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UNITED STATES OF AMERICA. 




TEXT-BOOK 

OF 

MATERIA MEDICA 
FOR NURSES 



COMPILED BY 



LAVINIA L. DOCK 

GRADUATE OF BELLEVUE TRAINING SCHOOL FOR NURSES ; SUPT. OF 
GRACE MEMORIAL HOUSE. 



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KK4SHH 



G. P. PUTNAM'S SONS 

NEW YORK LONDON 

B7 W8ST TWENTY-THIRD ST. 27 KING WILLIAM ST., STRAND 

1890 






Copyright 1890 

BY 

LAVINIA L. DOCK 



05-Htfto 



Hbe Ikntcfterbocfcer ipress, Iftew Jgdcfe 

Electrotyped, Printed, and Bound by 
G. P. Putnam's Sons 



PREFACE. 



The study of materia medica is made, to some ex- 
tent, a part of the course in all our training schools for 
nurses ; but, so far, no text-book has been prepared 
along the special lines followed in class recitations. 

Those special lines are well denned, and are limited. 
They begin and end with medicines, and do not run 
into therapeutics. The application of medicine to dis- 
ease is no part of a nurse's study, and there are there- 
fore some inconveniences met with in using — as text- 
books — works on materia medica which are written 
solely for the use of the medical profession. 

Large works, containing all the points which a nurse 
needs to know, contain also an immense amount of mat- 
ter with which she has nothing to do, and are very ex- 
pensive ; while those which are more concise usually 
presuppose a large amount of information, and are, in- 
deed, not intended to be used at the beginning of a 
course of study, but rather at the end. 

It is in the hope of filling this middle place that this 
text-book has been compiled, and the attempt made to 
collect from all available sources the scattered points 
which concern a nurse, and to give them simply and 
directly. The outlines followed are those of the classes 
in materia medica as taught in Bellevue Training School 
for Nurses, and include something of the source and 
composition of drugs ; their physiological actions ; signs 
indicating their favorable or unfavorable results ; the 
symptoms of poisons with their antidotes ; and practical 
points on administration. 

For material I am indebted to the following works : 
" Materia Medica and Therapeutics," by Dr. H. C. Wood ; 



IV PREFACE. 

"Quiz Compendof Materia Medica," by Dr. S. O. Potter ; 
" Materia Medica and Therapeutics," by Dr. R. Bartho- 
low ; " Lectures on Materia Medica and Therapeutics," 
by Dr. Thomson, edited by Dr. Le Fevre ; " Manual 
of Pharmacology, Therapeutics, and Materia Medica,"' 
by Dr. T. Lauder Brunton ; " Materia Medica and 
Therapeutics," by Dr. J. Mitchell Bruce ; and 
Dr. Farquharson's " Guide to Therapeutics and Materia 
Medica," edited by Dr. Woodbury. 

I gratefully acknowledge the kind permission accorded 
by the authors and publishers of the first five works to 
make extracts from them. For the use of the two lat- 
ter I am indebted to the courtesy of Messrs. Lea Brothers. 
Sincere thanks are due also to Dr. Charles Rice for 
much kindness in giving assistance and information, 
and in contributing a table of comparison between 
minims and drops ; and to Dr. George Dock for revi- 
sion and corrections and for many practical suggestions. 
The classification follows that used by Dr. Brunton 
and Dr. Bruce. The doses are taken from Dr. Wood's 
" Materia Medica and Therapeutics." 



CONTENTS. 



PAGE 

'art i. — The Inorganic Materia Medica : 

The Alkalies and Alkaline Earths ..... I 

The Metals 18 

Non-Metallic Elements 47 

Inorganic Acids ........ 61 

Organic Acids . . . . . . . .66 

The Carbon Compounds ...... 73 

Part II. — The Organic Materia Medica: 

The Vegetable Kingdom ....... 108 

The Animal Kingdom ....... 188 

Appendix 195 

Index . 199 



TEXT-BOOK OF MATERIA MEDICA 
FOR NURSES 



PART I. 

THE INORGANIC MATERIA MEDICA. 

THE ALKALIES AND ALKALINE EARTHS. 

The word " alkali " is formed from two Arabic words, 
" al," meaning " the," and ''kali," the name of a plant 
from the ashes of which soda was obtained. 

Chemically, an alkali is one of a class of caustic bases, 
the term "base" being given to the principal element of 
a compound. The chief characteristics of an alkali are 
comparatively well known : it unites with oils and fats to 
form soaps ; neutralizes acids and forms with them fresh 
compounds known as salts, which possess properties dif- 
fering from those of either constituent ; turns red litmus 
paper blue ; and is soluble in water. 

Those alkalies which are obtained in a solid state, viz., 
soda and potash, are termed "fixed," while ammonia, by 
reason of its gaseous nature, is called a " volatile " alkali. 

An alkaloid is an alkaline principle found in the tis^ 
sues of plants or animals ; more soluble in alcohol than 
in water, and having a definite composition as regards 
the proportions of its chemical elements. This, compo- 
sition is different from that of an alkali. An alkaloid 
also unites with acids to form salts, and these salts have 



2 MATERIA MEDIC A FOR NURSES, 

the same physiological and therapeutic actions as the 
alkaloid. 

Potassium (Potash). 

There are three great natural sources from which 
potash and its salts are derived, viz. : i. Wood ashes. 
2. Argol, the deposit left in wine-casks during the fer- 
mentation of grape-juice. 3. Beds of saline earths, 
found chiefly in India, but also to some extent in other 
countries. 

Physiological Actions. 

Potassium depresses the muscular, nervous, and cardiac 
tissues. Given long or in concentrated doses it destroys 
muscle and nerve tissue and nerve-centres. 

It is extremely diffusible, and is rapidly excreted, 
principally by the kidneys, but also to some extent by 
the salivary, mammary, and intestinal glands, and by 
the skin. 

In the living organism it is found chiefly in the blood 
corpuscles and muscles. 

Being so quickly removed from the body, the danger 
to the tissues, even from large doses, is comparatively 
slight, except when there is disease of the excretory 
organs, or when it is given for a long time, and under 
these circumstances a dyscrasia or unhealthy condition 
results, characterized by impoverishment and excessive 
fluidity of the blood. 

Symptoms of Poisoning. 

In poisoning by the salts of potash there is violent in- 
flammation of the alimentary canal ; intense burning pain 
about the epigastrium ; nausea and vomiting, sometimes 
of bloody mucus ; and profuse and watery, sometimes 
dysenteric, stools. With these there are the symptoms 
of depression of the general system : a weak, rapid 
pulse ; shrunken face ; cold skin ; coma ; and insensi- 
bility. There is sometimes paralysis of the lower limbs, 
and death may occur with great suddenness. 



THE ALKALIES AND ALKALINE EARTHS. 3 

Treat7nent of Poisoning. 

In potash poisoning dilute vinegar, lemon juice, and 
cider are given as antidotes ; the stomach and bowels 
are emptied, and oils, with bland demulcent drinks, such 
as gum tragacanth, barley water, flaxseed tea, milk, white 
of egg, or gruel, given to relieve the irritation of the 
mucous membrane, and stimulants to sustain the heart. 

Preparations of Potassium. 

Potassii Carbonas. 
Carbonate of Potash. 

The potash of commerce occurs in the form of fused, 
stony masses, of variegated color. Purified so as to form 
pearlash, it has a bluish-white color. Further purified, 
it becomes a white crystalline powder, which liquefies 
on exposure to the air by absorbing moisture from it. 
Dose, gr. ii.-x. 

Potassii Bicarbonas. 
Bicarbonate of Potash. 

Saleratus. — Made by passing carbonic-acid gas 
through a solution of the carbonate of potash in distilled 
water, and re-crystallizing. It is not deliquescent 1 nor 
corrosive, nor as irritating as the carbonate ; otherwise 
their qualities are the same. They are antacid sto- 
machics and mild diuretics ; stimulants of the liver ; 
expectorants, and have some slight diaphoretic 
action. 

In small doses on an empty stomach they promote the 
formation of gastric juice by increasing the diffusion of 
the blood constituents from which the gastric juice is 
formed. Large doses irritate the stomach, and, taken 
during digestion, decompose the gastric juice. 

These salts are given before or after meals according to 
the effect desired. The alkalinizing action on the stom- 
ach and kidneys is more pronounced when they are 

1 Melting by absorbing moisture from the air. 



4 MATERIA MEDIC A FOR NURSES. 

taken during digestion. They must be well diluted, in 
mucilaginous or sweetened water. Dose, gr. v.- 3 i. 

Liquor Potassii. 
Solution of Potash. 

Made by boiling slaked lime in a solution of the car- 
bonate of potash. Dose, TT], ii-xv. (= gtt. ii.-xv.), well 
diluted with sweetened water or mucilage. 

Potassa. 
Caustic Potash. 

Made from liquor potassii by boiling down and run- 
ning into moulds. Grayish-white pencils, hard but very 
deliquescent. 

Caustic potash is very powerfully corrosive. When 
applied to the skin it melts slowly, destroying the tissues 
by its affinity for moisture and power of dissolving albu- 
min. Its application is very painful and great care is 
required to avoid injury to the surrounding tissues. It 
differs from nitrate of silver in extending its action far 
below the surface ; for this reason it is used in cases 
which require deep-reaching action. The healing pro- 
cess takes place more slowly after the application of caus- 
tic potash than after that of any escharotic in use. A 
grayish slough is formed, with inflammation of the parts 
near by. The slough remains for a time varying from six 
to twelve days, when it separates, leaving a rather indolent 
ulcerated surface. 

In using caustic potash the surrounding tissues should 
be protected by adhesive plaster, having a hole cut in it 
the size of the spot to be cauterized. The surface of the 
plaster is oiled, but the oil must not touch the skin. After 
sufficient action has been obtained, and the plaster re- 
moved, the spot may be washed with dilute vinegar. 

In cases of poisoning by caustic potash, the corrosive 
action is seen about the lips and fauces in bloody oozing, 
sloughs of mucous membrane, and vomiting of shreds of 
sloughing and bloody tissue. Deformity of the mouth 
and contraction of the oesophagus and of the cardiac and 



THE ALKALIES AND ALKALINE EARTHS. 5 

pyloric orifices may remain after recovery, interfering 
mechanically with nutrition, and resulting in death after 
periods of time varying from six weeks to one or two 
years. 

Potassii Citras. 
Citrate of Potash. 

Made by neutralizing citric acid with carbonate of 
potash and evaporating. The least unpleasant of all the 
preparations of potash except the tartrates. It has diu- 
retic and refrigerant diaphoretic action. In the 
blood it is decomposed, and is excreted by the urine 
in the form of alkaline carbonate. Dose, gr. v.- 3 ss., 
well diluted. 

Potassii Acetas. 
Acetate of Potash. 

Made by saturating acetic acid with bicarbonate of 
potash, evaporating, and solidifying. 

It is antacid, strongly diuretic, and, in large doses, 
mildly cathartic. It increases the flow of urine and 
diminishes the secretion of urea and uric acid. Dose, 
gr. x.- 3 i., largely diluted. 

Potassii Chloras. 
Chlorate of Potash. 

Made by passing chlorine gas into a mixture of carbo- 
nate or chloride of potash and slaked lime ; boiling, 
evaporating, and re-crystallizing. Soluble in 16 parts of 
cold and 2\ parts of boiling water. 

Physiological Action. 

Chlorate of potash acts as a stimulant to mucous mem- 
branes and ulcerated surfaces, and its use as an applica- 
tion for sore throat is familiar. In medicinal doses it has 
no marked effect upon the system, but taken continuously 
it is very irritating to the kidneys and causes chronic 
nephritis or inflammation of those organs. 



D MATERIA MEDIC A FOR NURSES. 

This fact is not very generally understood among non- 
professional people, and chlorate of potash is used to 
excess by numbers of persons, without the authority of a 
physician, under the impression that it is perfectly harm- 
less. A nurse has many opportunities of observing 
habits of this kind and should use all her influence to 
discourage them. Chlorate of potash is eliminated un- 
changed by the urine. 

Symptoms of Poisoning. 

Taken in sufficient quantities chlorate of potash is 
a powerful poison and has often caused death. The 
symptoms may be acute or subacute. In the former 
case there are violent vomiting, profuse diarrhoea, and 
great dyspnoea and cyanosis. After death, which occurs 
from heart failure, the blood is of a chocolate color. In 
subacute cases there are severe gastro-intestinal symp- 
toms ; vomiting of blackish-green matters and swelling 
of the liver and spleen. The urine is albuminous, dimin- 
ished, and sometimes suppressed. Its color is dark, 
reddish brown, or black, and under the microscope the 
detritus of red blood corpuscles, which had choked the 
tubules of the kidney, may be seen. The nervous symp- 
toms are headache, loss of appetite, great pains in the 
abdomen and other parts of the body, marked abdominal 
tenderness, tonic and clonic cramps, a peculiar stiffness 
of the extremities, dilirium, and coma. Small ecchy- 
moses * sometimes appear on the surface of the body, 
and there is frequently a general jaundice. In some 
cases there is a fatal relapse after the patient seems in a 
fair way to recover. The smallest poisonous dose is not 
known, but in one case death was caused by a little over 
§ ss. A child one year old died from 3 i. given in a 
night, and a child of three years from 3 iii- In one case 
death took place a week after taking § i. 
Dose, gr. x.-xxx., well dilated. 

1 Discolored spots caused by the escape of blood into the tissues. 



THE ALKALIES AND ALKALINE EARTHS. 7 

Potassii Ferrocyanidum. 
Ferrocyanide of Potash. 

Made by fusing animal substances with carbonate of 
potash and iron ; with various further processes. Used 
for testing, and to make hydrocyanic acid and cyanide 
of potash. 

Potassii Cyanidum. 
Cyanide of Potassium. 

Made by heating together the ferrocyanide and car- 
bonate of potash. It has the odor of hydrocyanic acid 
and similar though somewhat alkaline taste. It is solu- 
ble in water. When taken into the stomach the acids 
there convert it into hydrocyanic acid. 

Physiological Actions. 

The physiological, therapeutic, and toxic effects of this 
salt are like those of hydrocyanic acid. Death, how- 
ever, does not occur so soon, and insensibility is some- 
times not manifested for several minutes. Cases of 
poisoning have occurred from inhalation of the vapor ; 
also from absorption through the hands, among photogra- 
phers. There is, usually, little time to employ treatment. 
A weak solution of sulphate of iron has the effect of 
decomposing the poison and converts it into Prussian 
blue. Cold affusions and other treatment, the same as 
used for hydrocyanic-acid poisoning, may be tried. 
Death has been caused by gr. v. 

A solution of cyanide of potash, in the strength of 2 
to 4 grains in § i. of water, will remove the stains of 
nitrate of silver. 

Dose, gr. T V~A- 

Potassii Bitartras. 
Bitartrate of Potash. 
Cream Tartar. 

Made from argol, and from lees of wine by purifica- 
tion and evaporation. White crystalline masses of pleas- 
ant acid taste, not readily soluble in water, requiring for 



8 MATERIA MEDICA FOR NURSES. 

solution in cold water about 180 parts, or more. An active 
diuretic and hydragogue l cathartic. It is agreea- 
bly given as " cream of tartar lemonade." The quantity- 
ordered is dissolved in hot water, and when cool, the 
clear solution is poured off, flavored with lemon juice, 
and sweetened to taste. In excessive doses it will pro- 
duce gastro-intestinal troubles, and one case of poisoning 
is recorded after taking over § ss. 

Potassii Nitras. 
Nitrate of Potash. 
Saltpetre. 

Obtained for medicinal use chiefly by purification of 
native nitre found in beds of saline earths in India. It 
is also found in saltpetre caves in the United States, and 
is manufactured artificially in nitre beds formed of ani- 
mal and vegetable matter, wood ashes, and calcareous 2 
earth ; and, finally, is obtained from old plaster rubbish. 

Nitre is refrigerant, diaphoretic, diuretic, and in 
large doses laxative. In excessive or concentrated 
doses it may act as a fatal poison, producing gastro- 
enteritis and derangement of the nervous system. 

Symptoms of Poisoning. 

Burning pain in throat and stomach ; bloody stools ; 
syncope ; collapse, and death, sometimes preceded by 
convulsions. Death has been caused by § i., but when 
in weak solution much larger quantities may be safely 
taken than would cause death if concentrated. There is 
no known antidote. Mucilaginous drinks should be 
given, vomiting freely promoted, and the stomach-pump 
used. 

Dose, gr. ii.-x. well diluted with barley water or other 
demulcent. 

Potassii et Sodii Tartras. 
Tartrate of Potassium and Sodium. 
Rochelle Salt. 

Made by adding carbonate of soda to a solution of 
bitartrate of potash. A mild saline purgative, less effi- 

1 Producing watery evacuations. 
2 Containing lime. 



THE ALKALIES AND ALKALINE EARTHS. g 

cient but less offensive to the taste than Epsom salt. It 
should be largely diluted, and acts better if given very- 
hot or very cold. If given in hot water, the addition of 
tr. ginger, gtt.-x. xv., makes it more agreeable to the 
taste If cold, it may be given in seltzer or carbonated 
water. It should be given early in the day and on an 
empty stomach. 

Sodium (Soda). 

There are four natural sources of the officinal salts of 
sodium and their preparations, viz. : 
i. Sodium, a metallic element. 

2. Chloride of sodium, or common salt, obtained from 
sea-water by evaporation and from salt mines. 

3. Nitrate of sodium, found native in Chili and puri- 
fied by crystallization from water. 

4. Borax ; a native product found in various localities. 

Physiological Actions. 

The salts of sodium are absorbed into the blood and 
excreted from it more slowly than the salts of potassium, 
and for this reason the action of soda upon the alimen- 
tary canal is stronger than that of potash. It is diuret- 
ic, but not as strongly so as potash ; antacid, and 
purgative. It is less depressing than potash and more 
easily borne by the stomach. The sodium salts are 
taken into the organism in large quantities with food, 
especially vegetables and fruits, and are the chief source 
of the natural alkalinity of the blood. Sodium is excreted 
by all the mucous surfaces, by the kidneys, the liver, and, 
possibly, by the skin. 

Sodii Chloridum. Chloride of Sodium. 
Common Salt. 

Salt performs a very important part in the human 
economy. It exists normally in the blood in the propor- 
tion of 4 to 1000, and is very abundant in various normal 
secretions. Active tissue changes are promoted by the 
presence of salt. It stimulates the desire for food, and 



10 MATERIA MEDIC A FOR NURSES. 

aids in its thorough alteration and absorption. It is the 
natural antiseptic of the blood ; aids osmosis, 1 and keeps 
the fibrin and albumin of the blood in solution. Water 
alone is injurious to cut tissues, but a weak solution 
of salt makes it non-irritant. During the course of an 
inflammation chloride of sodium, being needed for its 
solvent action, accumulates in the inflamed area, disap- 
pearing temporarily from the urine. This is notably the 
case in pneumonia, and the return of the chloride to the 
urine marks a favorable change in the condition of the 
patient. In substance or in strong solution it is irritat- 
ing to cut surfaces, mucous membranes, muscle and 
nerve tissue. Taken into the stomach in large quantities 
it causes vomiting, and when absorbed in excess of the 
needs of the system it causes the nervous irritation which 
produces the sensation of thirst, and which is relieved by 
taking enough water to dissolve the salt and carry it 
away to be excreted by the kidneys. Salt dissolves in 2f 
parts of water. 

In convalescence patients often crave some salty arti- 
cle of food which, being indigestible, must be denied 
them, but the need of the system which is thus expressed, 
may be satisfied by giving salt in another way. 

In feeding babies and young children a pinch of salt 
should always be added to the milk, as its action opposes 
the formation of hard curds in the milk. 

Salt water in strong solution is an anthelmintic. 2 

Sodii Carbonas. Carbonate of Soda. 
Sal Soda. Washing Soda. 

Made chiefly from common salt, and from the sulphate 
of sodium. Transparent colorless crystals, soluble in 
two parts of water. Its effects are similar to those of the 
carbonate of potassium, but it is rarely used medicinally. 
In large quantities it is an irritant poison for which 
oils and acids are the antidotes. It is an excellent 
material for cleaning glass, china, and wood. Poured in 

1 The force by which fluids pass through moist membranes. 
2 A remedy which kills or expels intestinal worms. 



THE ALKALIES AND ALKALINE EARTHS. II 

strong solution into drains and water-pipes it carries 
away grease. It will remove the stains made by bichloride 
of mercury on china and glass. 

Sodii Carbonas Exsiccatus. 
Dry Carbonate of Soda. 

The powdered carbonate is used externally as in an 
ointment ; strength 3 i. to § i., with laudanum ; or, in 
solution, is added to the bath. 

Sodii Bicarbonas. 
Bicarbonate of Soda. 

Prepared by saturating the carbonate with carbonic- 
acid gas. Soluble in 12 parts water (saturated solu- 
tion). Bicarbonate of soda has a soothing action in 
burns, eruptions, and irritation of the skin. Dose, as an 
antacid, gr. x. — xx. It is pleasantly administered in 
carbonated water — Seltzer or Vichy. 

Pulvis Effervescens Compositus. 
Compound Effervescing Powder. 
Seidlitz Powder. 

Seidlitz powder is put up in two packets, a white paper 
containing gr. xxv. of tartaric acid (the acid of grapes), 
and a blue one containing gr. xl. of bicarbonate of soda 
and gr. cxx. or 3 ii. of Rochelle salt. They are dis- 
solved separately in very cold water, the acid in one or 
two ounces, and the salt in five or six. They are then 
poured together and taken after the first escape of gas, 
while still effervescing. It is hardly necessary to say 
that they should not be mixed at a distance from the 
patient, but at his side and at the precise moment when 
he is ready to take the dose. The glass must be large, to 
allow for the effervescence, and it is well to have a saucer 
under it, to avoid the annoyance of having it effervesce 
over the top and sides. The powders must be. kept dry. 
Exposed to the air they become damp and lose their 
effervescing quality. Seidlitz powder is refrigerant and 
laxative, and should be given in the morning on an 



12 MATERIA MEDIC A FOR NURSES. 

empty stomach. One powder is usually sufficient for a 
dose, acting in from three to six hours. 

Sodii Boras. Borate of Soda. 
Borax. 

Borax is found as a native product in several localities. 
It is also artificially made by combining native boric acid 
with soda. On the skin it acts as a soap — removing the 
epidermis. Added to " hard " water, it softens it pleas- 
antly for bathing purposes, and is useful in many local 
and external applications by means of its cleansing 
properties. 

Lithium. 

Lithium is obtained from several minerals, and traces 
of it are found in certain mineral waters. 

Lithium salts have strong alkaline properties, and act 
on the human organism as do the other members of the 
group. It is stated that lithium salts alkalinize the 
urine more decidedly even than salts of potassium. 

Preparations. 

Lithii Carbonas. Carbonate of Lithium. Dose, gr. ii.-x. 
Lithii Citras. Citrate of Lithium. Dose, gr. v.-x. 
Lithii Benzoas. Benzoate of Lithium. Dose, gr. ii.-xv. 
Lithii Salicylas. Salicylate of Lithium. Dose, gr. v.-xv. 

Ammonia (Ammonia). 

Ammonia is a gaseous compound of hydrogen and 
nitrogen ; colorless, irrespirable, highly irritant, of strong 
alkaline reaction and pungent odor. It is obtained in 
the manufacture of coal gas, and occurs as a result of 
the decay of organic substances. 

Physiological Actions. 

Applied to the skin, ammonia is a powerful irritant, 
causing redness, blistering, and sloughing. Inhaled, it 
causes severe irritation of the air-passages, with sneezing, 



THE ALKALIES AND ALKALINE EARTHS. 1 3 

disturbed respirations, flow of water from the eyes and 
nose, and quickened pulse. Ammonia acts as a general 
Stimulant to the heart and nervous system, especially 
the spinal cord and respiratory centre. Being rapidly 
diffused, its action is prompt but somewhat transitory. 
It is excreted by the kidneys and mucous membranes. 

Symptoms of Poisoning. 

In large amount ammonia is a corrosive poison, pro- 
ducing violent abdominal pain, vomiting and purging of 
bloody matters, with convulsions, collapse, and death. 
Consciousness may remain until the last, or coma may 
precede death. In some cases death has taken place 
within five minutes, having been caused probably by 
oedema of the larynx. The symptoms come on at once 
in poisoning by ammonia. 

Treatment of Poisoning. 

Dilute vinegar or lemon juice are given to counteract 
the alkali ; oils and bland liquids to soothe the mucous 
membrane, which is corroded. Heat favors the action 
of ammonia, and cold antagonizes it ; therefore, in pois- 
oning by ammonia plenty of cold fresh air should be 
admitted, if possible, and cold applications made to the 
head. The feet must be kept warm. 

Preparations of Ammonium. 

Ammonii Chloridum. 
Chloride of Ammonium. 
Sal Ammoniac. 

Made by neutralizing ammoniacal gas liquor with 
hydrochloric acid, evaporating, and purifying. The 
action of chloride of ammonia on the skin is soothing" 
rather than irritating, as applied in lotions. It has a 
cooling effect, and is a tonic to the sensory nerves, and 
reduces local external inflammation. It has a stimulant 
action on the liver ; is diuretic and diaphoretic, and, 
like other preparations of ammonia, a stimulant ex- 



14 MATERIA MEDIC A FOR NURSES. 

pectorant. The taste is very nauseous, resembling 
sea-water. 

Dose, gr. v.-xx., well diluted with cold water. 

Ammoniae Carbonas. 
Carbonate of Ammonia. 

Made by subliming a mixture of chloride of ammonia 
and carbonate of calcium. A very active and quickly 
diffusible Stimulant to the heart and respiration, and 
an expectorant, acting in the latter capacity by liquefy- 
ing the bronchial secretions, which are thus more easily 
raised, and the air-cells kept free. In large doses (gr. 
xxx.) carbonate of ammonia acts as an emetic. It has 
a nauseous taste, is very pungent, and must be well 
diluted. It may be given in milk. 

Dose, gr. v.-x. 

Aqua Ammoniae Fortior. 
Strong Water of Ammonia. 

Made by heating chloride of ammonia with slaked 
lime and collecting the gaseous product in water. It 
has a strength of 26 per cent, and has been used as an 
application to the bites of poisonous animals or serpents. 
It may be used as a vesicant, but its action is apt to be 
more severe than is desirable. It acts more quickly than 
cantharides, and does not affect the urinary organs. 

Aqua Ammoniae. 
Water of Ammonia. 
Hartshorn. 

A solution of the gas in water, 10 per cent, in strength. 
It may be used externally as a counter-irritant. Ap- 
plied in dilute solution to the bites made by insects, it 
relieves the sting. Taken internally, it is a general 
stimulant and antacid. 

Dose, TI| v.-xxv. (Til x. = gtt. x.). largely diluted. 

Spiritus Ammoniae Aromaticus. 
Aromatic Spirit of Ammonia. 
Sal Volatile. 

Contains aqua ammonise, and 4 per cent, of the car- 
bonate, with oil of nutmeg, of lemon, and of lavender ; 



THE ALKALIES AND ALKALINE EARTHS. 1 5 

alcohol and water. It is an antacid and stomachic, 
overcoming a feeling of nausea, and a general stimulant. 
It is not unpleasant. 

Dose, 3ss.-3i. (""I x, = gtt. xxv.), well diluted in 
milk or water. 

Liquor Ammoniae Acetatis. 
Solution of the Acetate of Ammonia. 
Spirit of Mindererus. 

Made from carbonate of ammonia and acetic acid. It 
is more active than the other preparations, as a dia- 
phoretic, especially if the body be kept warm. If the 
skin be kept cool, its diuretic action is more pro- 
nounced. It is also a nervous stimulant. Dose, 3 i- 
3 iv., well diluted with water. 

Linimentum Ammoniae. 
Liniment of Ammonia. 

A mixture of 30 parts aqua ammoniae with 70 parts 
cotton-seed oil. 

Raspail's Sedative Water. 

A mixture of aqua ammoniae, chloride of sodium, and 
camphorated spirits of wine, with water. For sponge 
baths ; cooling and sedative. 

Calcium (Lime). 

Lime is obtained from four sources : 1. Chalk. 2. 
Marble. 3. Native sulphate, or plaster-of-Paris. 4. 
Bone-ash. Lime is an exceedingly important constituent 
of the body, being found, in the form of solution of 
phosphate of lime, in every animal tissue and fluid. It 
gives solidity to bones, and accumulates wherever rapid 
tissue changes are taking place. The preparations of 
lime are antacid and slightly astringent. Locally 
they are sedative to mucous membrane. Lime is a 
valuable antidote in poisoning by oxalic acid, chloride 
of zinc, and the mineral acids. It can always be obtained 
for this purpose in the form of wall-plaster or whitewash. 



1 6 MATERIA ME DIC A FOR NURSES. 

Preparations of Calcium. 

Calx. 

Lime. 

Made from chalk or limestone by calcining (purifying 
and rendering friable by the action of heat). In this 
state it has the form of compact white masses, which 
readily absorb water, crack, evolve heat, and fall into 
powder. It is then called calcii hydras, slaked lime, or 
quick-lime. If it should come in contact with the eye it 
should be washed out with a solution of sugar. 

Liquor Calcis. 
Lime-Water. 

Lime-water is a saturated solution of lime containing 
about f of a grain to § i. of water. It is made by wash- 
ing slaked lime and shaking it up in distilled water, 
preferably, though ordinary water may be used. After 
it settles, the water is poured off from the sediment and 
strained. It is colorless, inodorous, and has a disagree- 
able alkaline taste. By exposure to the air it absorbs 
carbonic acid, and should therefore always be kept well 
corked. Lime-water acts as a gastric sedative, and 
added to milk prevents its curdling in large lumps. The 
ordinary proportion is lime-water § ss. to milk § v., in- 
creased, according to circumstances to \ or even \ lime- 
water. Lime-water is slightly constipating. 

Syrupus Calcis. 
Syrup of Lime. 

Five parts of lime to one hundred parts syrup. Dose, 
3i. 

Linimentum Calcis. 
Carron Oil. 

A mixture of lime-water and olive oil or linseed oil, in 
equal parts, for external use. It is an excellent appli- 
cation for burns, and has the merit of cheapness. 



THE ALKALIES AND ALKALINE EARTHS. 1 7 

Creta Praeparata. 
Prepared Chalk. 

Made from chalk by a cleansing and drying process. 
A smooth white powder, insoluble in water, and of as- 
tringent action. Externally, it is used as a dusting- 
powder. When taken internally it may be administered 
in glycerine or syrup. Dose, gr. v.- 3 i. 

Mistura Cretae, 
Chalk Mixture. 

Contains prepared chalk gr. xxx. to § i., and is an 
astringent. Dose, 3 L- § ss. 

Magnesium (Magnesia). 

The officinal preparations of magnesia are all derived, 
directly or indirectly, from the sulphate. 

Physiological Actions. 

Magnesia, in the form of the oxide and carbonates, 
forms insoluble and comparatively harmless compounds 
with the mineral acids. It is therefore used as an anti- 
dote for these poisons, the oxide being preferable, and to 
be very freely given. 

Magnesia has antacid, purgative, and diuretic 
qualities. Entering the circulation, it increases the al- 
kalinity of the plasma, and is partly excreted by the 
kidneys, rendering the urine more abundant and less 
acid. 

Preparations of Magnesiaum. 

Magnesii Sulphas. 
Sulphate of Magnesia. 
Epsom Salt. 

Made from dolomite, or magnesian limestone, by solu- 
tion in sulphuric acid and purification. A quickly acting 
hydragogue cathartic, easily borne by the stomach, 
though of nauseous taste. Ordinary laxative doses act 
in a few hours. Large doses ( 3 i.-ii.) produce a result 



1 8 MATERIA MEDIC A FOR NURSES. 

almost immediately, and cause griping and abdominal 
distension. It should be given well diluted and on an 
empty stomach. It is soluble in 2\ parts of water. 
Dose, | ss., in carbonated, Seltzer, or Vichy water. 

Liquor Magnesii Citratis. 
Citrate of Magnesia. 

In small does a laxative, in large ones cathartic, 
acting in from four to six hours. It is effervescent, and 
should be kept cold and taken at the moment it is poured 
out. If the whole amount is not taken at once the bot- 
tle should be stood on the corked end or laid on its side. 
Dose, § iv.-vii. 

Magnesii Citras Granulatus. 
Granular Citrate of Magnesia. 

A white coarse-grained salt of refreshing taste, very 
soluble and effervescent, acting in the same way as the 
liquor. 

Dose, 3 i.-iv. stirred up in cold water. 

Cerium (Cerium). 

A metal of which the oxalate only is used. 

Cerii Oxalas. 
Oxalate of Cerium. 

A white granular powder, insoluble in water, alcohol, 
or ether. It is a gastric sedative, and is given dry on 
the tongue. Dose, gr. v.-xx. 

THE METALS. 

Plumbum (Lead). 

Lead is found native in small masses. It is a dull, 
whitish metal with a tint of blue, and is not given in its 
native state, medicinally, but in the form of salts. 



THE METALS. 1 9 

Physiological Actions. 

The special property of the lead salts is astringency, 
and they are, in consequence, sedative, anti-phlogis- 
tic, 1 and haemostatic. 2 

Used in dilute solutions externally as applications to 
ulcers, mucous surfaces, etc., they precipitate the albumi- 
nous fluids which cover the surface, contract the small 
blood-vessels, and harden the tissues of the young grow- 
ing cells. Applied in concentrated solutions, they are 
irritant, causing inflammation, or increasing it. Taken 
internally, their action is first evident as a peculiar as- 
tringent taste, with a dry feeling of the throat. In the 
stomach and intestines the same action is shown. Lead 
dries the secretions, contracts the vessels, and checks 
peristaltic action, thus causing constipation. 

It is changed by the intestinal juices into an albuminate, 
and so enters the blood. It is rapidly deposited in the 
tissues, especially in the central nervous system, the kid- 
neys, liver, and bones. It is excreted, but slowly, in the 
bile, the urine, and perspiration ; also by the mammary 
glands. It diminishes the excretion of uric acid by the 
kidneys. 

Poisoning by Lead. 

Acute lead poisoning is rare, and will be spoken of in 
connection with the acetate. Chronic poisoning is quite 
common, the poison being introduced into the system in 
one or more of the following ways : By absorption 
through the unbroken skin, as in the case of painters, 
glaziers, etc. — the fine particles of metal which are rubbed 
off and adhere to the skin being changed by its secre- 
tions into soluble salts which are readily absorbed ; by 
absorption through ulcers, wounds, etc., from the exces- 
sive application of ointments ; by the use of food put up 
in cans soldered with lead, cooking utensils made of 
painted wood or imperfectly burnt pottery, and by eating 
buns, cake, etc., colored with chromate of lead ; by the 

1 Opposed to inflammation. 2 Checking hemorrhage. 



20 MATERIA MEDICA FOR NURSES. 

habit of biting silk thread adulterated with lead ; by 
sleeping or working in newly painted rooms, and by the 
poisoning of a water supply from lead pipes. This 
does not occur with " hard " water — viz., that contain- 
ing salts of lime, as an insoluble coating is then deposited 
on the lining of the pipes ; but with pure, or " soft " 
water, the lead is slowly dissolved in the form of a car- 
bonate. The first symptoms of poisoning are : A feeling 
of pain, with a sense of sinking in the region of the 
navel ; loss of appetite, thirst, and dryness of the mouth 
and throat, with a metallic astringent taste ; pale face 
and skin generally ; fetor of the breath ; constipation ; 
emaciation and wasting of the muscles, especially those 
of the arms ; swelling of the joints, and rheumatic pains. 
Colic is a very pronounced symptom, sometimes coming 
on very suddenly, sometimes after several days' illness. 
The pain is intense and varies in character, sometimes 
being sharp, sometimes dull, or, again, " twisting," and 
seems to centre about the umbilicus. This fact of its 
being localized differentiates it from hepatic colic, which 
goes through to the back, and from renal colic, which 
radiates along the line of the ureters. The abdominal 
walls are violently retracted and rigid, and neuralgic 
pains seize the abdominal muscles and shoot along those 
of the thorax and extremities, especially the flexors. The 
skin and conjunctivae sometimes become jaundiced, and 
the urine tinged with bile. 

A very striking feature of lead poisoning, occurring 
both in acute and chronic cases, is the dark slate-colored 
line on the gums along the margin of the incisor teeth. 
It is said to be more marked in those cases where the 
tooth-brush is not used. 

The chronic nervous symptoms of lead poisoning may 
be developed after the first attack of colic, or they may 
come on without marked abdominal disturbance. The 
most common and noticeable one is the paralysis of 
the extensor muscles of the forearms, causing what is 
termed " wrist-drop." With this there is sometimes 
either partial or complete anaesthesia of the affected 
members. 



THE METALS. 21 

Paralysis of the laryngeal muscles sometimes occurs, 
resulting in aphonia. 1 The pulse is incompressible and 
tense, full, and infrequent. There may be anaesthesia of 
the optic nerve, as a result of the direct action of lead, 
or dimness of sight may result from the albuminuria, 
which is often present ; and, finally, there may be a con- 
dition of cerebral disturbance known as " encephalopathia 
saturnina," or lead encephalopathy, beginning with head- 
ache, and characterized by delirium, stupor, epileptiform 
convulsions, and coma. Death may follow, although 
severe cases have been known to recover. Death may 
also result from the gradual failure of nutrition, or from 
an extension of paralysis to the muscles of respiration. 

Treatment of Poisoning. 

In treating chronic lead poisoning, large doses of 
purgatives are given. Iodide of potash aids in elimina- 
tion of the poison, and baths of sulphide of potash are 
also used for this purpose. Workers in lead may guard 
against poisoning by personal cleanliness, which is of 
great importance, by the use of sulphuric-acid lemonade, 
and milk, as a food, in large quantities. 

Preparations of Lead. 

Oxide of Lead. 
Litharge. 

Made by roasting lead in a current of air. 

Plumbi Acetas. 
Acetate of Lead. 
Sugar of Lead. 

Made by the action of acetic acid on litharge. This 
is the only preparation of lead given internally. Acute 
poisoning has been caused by the acetate of lead, 
although, as it acts as an emetic, it is rarely fatal. The 
symptoms appear in from half an hour to two hours 
after taking it, and are essentially the same as described 

1 Loss of the voice. 



22 MATERIA MEDICA FOR NURSES. 

under chronic poisoning. Recovery may take place 
within a few days, although symptoms recur, occasion- 
ally, after a long interval. The fatal dose is between 
| i. and ii. The treatment consists of large doses of 
Glauber's and Epsom salts ; castor oil ; emetics, if vom- 
iting is not already excited ; opium ; and albuminous 
drinks freely given. 

Dose, gr. ii.-v., always in pill. 

Liquor Plumbi Subacetatis. 
Solution of Subacetate of Lead. 
Goulard's Extract. 

Used only externally. It should be diluted, in a 
strength of f i.-iv. to O i. of water. 

Ceratum Plumbi Subacetatis. 
Goulard's Cerate. 

Composed of white wax, olive oil, camphor, and Gou- 
lard's extract. For external use. 

Emplastron Plumbi. 
Lead Plaster. 
Diachylon Plaster. 

Made by boiling litharge with olive oil. It is the basis 
of most officinal plasters. 

Argentum (Silver). 

The metal silver itself is not used in medicine, and its 
preparations are not numerous. The properties of silver 
will be described under its most important salt. 

Argenti Nitras. 
Nitrate of Silver. 

Prepared by dissolving silver in nitric acid. 

Physiological Actio?is. 

Nitrate of silver has locally a caustic or corrosive 
action. It combines with the albumin of the tissues, 



THE METALS. 23 

forming a superficial slough. It has a strong metallic 
and styptic ' taste, and in the stomach produces a feeling 
of warmth. It is decomposed by the gastric juice, and, 
therefore, does not act as an irritant to the stomach, 
unless taken in poisonous doses. Silver enters the blood 
as an albuminate, and, if continued for some time, a part 
of it remains permanently in the connective tissues, 
staining them a dull slate-gray, which cannot be removed. 
This tinge first appears as a line along the gums and 
teeth, and on the mucous membrane inside the lips and 
cheeks. In small doses silver is astringent and anti- 
spasmodic, Stimulates secretion and nutritive pro- 
cesses, and is a nerve tonic. Long continued it 
disorders digestion, and produces a general waste of 
tissue, albuminuria, rapid and irregular heart action, 
disturbed respiration, and nervous symptoms, viz. : te- 
tanic convulsions, loss of the power of co-ordination, 
and paralysis. 

Symptoms of Poisoning. 

In toxic doses silver causes gastro-enteritis, and the 
antidote is common salt, given very freely in solution. 
It forms an insoluble chloride, and also acts as an 
emetic. 

Preparations of Silver. 

Dose of the nitrate, gr. J-J, in pill, given after meals, 
unless otherwise ordered. Nitrate of silver is quickly 
decomposed, if in solution, by organic matter and by the 
action of light, and is for that reason kept in dark-colored 
bottles, and should never be left uncorked. With tannin 
it forms an explosive compound. 
Argenti Nitras Fusus. 
Fused Nitrate of Silver. 
Lunar Caustic. 

Made by evaporating nitrate of silver and forming it in 
pencil-shaped moulds. It is used externally as a caustic. 

1 Dry and astringent. 



24 MATERIA MEDIC A FOR NURSES. 

It is not deliquescent ; its action is superficial and does 
not extend beyond the point touched ; and the slough 
formed is rapidly healed. In applying nitrate of silver 
the pencil should always be washed in an antiseptic 
solution before and after using, and especially before it is 
put away, carefully dried. 

Argenti et Potassii Nitras. 
Nitrate of Silver and Potash. 
Mitigated Stick. 

Made with equal parts of nitrate of silver and nitrate 
of potash. For local use externally, and is used as an 
application to the eyelids, 

Argenti Oxidum. 
Oxide of Silver. 

A brown powder, almost insoluble in water. With 
creasote and the chlorides it forms an explosive com- 
pound. It has a milder action than the nitrate. Dose, 
gr. ss.-ii. in pill. 

Zincum (Zinc). 

There are two sources of the salts and preparations of 
zinc, viz.: The metal, zinc, and the native carbonate, 
calamine. 

Physiological Actions. 

The salts of zinc are, in their stronger forms, caustic ; 
in weaker forms, astringent and antiphlogistic. The 

activity of the different preparations is in proportion to 
their solubility and diffusibility. Applied to a broken 
surface or mucous membrane, the salts of zinc harden 
the albuminous secretions, check the growth of new 
cells, and contract the vessels, though in a lesser degree 
than do lead and silver. The salts of zinc, in the blood, 
take the form of albuminates. They enter the circula- 
tion slowly, do not have the tendency to accumulate and 
remain fixed in the tissues as do lead, mercury, and 
copper, and are much more rapidly excreted. They are 
eliminated by the liver, kidneys, intestinal and mammary 
glands. 



THE METALS. 2$ 

Symptoms of Poisoning. 

If the use of zinc be long continued there may result a 
series of symptoms similar to those of lead-poisoning, 
though less severe — viz., wasting of the tissues and loss 
of strength ; pallor ; muscular weakness and trembling ; 
colic ; fetid breath and constipation ; feeble mind ; and 
paralysis. 

Treatment of Poisoning. 

In cases of acute poisoning by zinc salts the antidotes 
are lime-water, tannin, in the form of strong tea, carbo- 
nate of sodium or potassium, soap-suds, and mucilaginous 
drinks, milk, etc. Vomiting should be encouraged and, 
if necessary, the stomach washed out. 

Preparations of Zinc. 

Zinci Chloridum. 
Chloride of Zinc. 

Made by dissolving zinc which has been melted and 
poured into cold water, in dilute hydrochloric acid, and 
boiling. It then goes through several purifying pro- 
cesses. A whitish gray, deliquescent substance, soft, 
like wax, and with very corrosive and irritant action. 
It is used as a caustic and acts powerfully, causing 
destruction of the part, with severe pain, followed by 
sloughing which heals slowly. An impure solution 
known as Burnett's fluid, containing 200 grains to | i. of 
water, is sold as a disinfectant and has caused numerous 
cases of poisoning. The symptoms, which are those of 
severe gastro-enteritis and collapse, come on immedi- 
ately, and death may result in a few hours, or be delayed 
for several days. 

Zinci Sulphas. 1 
Sulphate of Zinc. 
White Vitriol. 

Made by dissolving zinc in dilute sulphuric acid, and 
crystallizing. Soluble in water. In small doses sulphate 

1 Zinc solution for the disinfection of white clothing. Sulphate of 
zinc, § ii. Common salt, § iv. Water, 1 gallon. Soak clothes for 
4 to 6 hours, boil, and wash. 



26 MATERIA MEDIC A FOR NURSES. 

of zinc has tonic and astringent properties. Contin- 
ued long in medicinal doses it may cause ulceration 
of the mucous membrane of the alimentary canal. Sul- 
phate of zinc is a specific emetic. It acts promptly, 
and entirely by its local irritant action, not being 
absorbed, and causing no flow of secretions. It is not 
constitutionally depressing, and causes but little nausea 
either before or after the act of vomiting. 

Dose (medicinal), gr. -jq-L 

Dose (emetic), gr. xv.-xx. largely diluted with warm 
water, and given every fifteen minutes until vomiting 
occurs. 

Zinci Oxidum. 
Oxide of Zinc. 

A yellowish white powder, insoluble in water, and used 
principally to dust over the skin as an astringent. 
Sometimes used as an astringent internally. 

Dose, gr. ss.-v. 

Unguentum Zinci Oxidum. 
Zinc Ointment. 

Made of oxide of zinc, usually twenty parts, to ben- 
zoinated lard — eighty parts. 



Cuprum (Copper). 

The action of copper is very similar to that of silver 
and zinc. Metallic copper is inert. The salts are not 
absorbed by the unbroken skin, but applied to mucous 
membranes and exposed tissues they are caustic, 
Stimulant, and astringent. Internally in small doses 
they have the two latter, and also tonic, qualities ; and 
in large doses act on the stomach as irritants, causing 
vomiting, and on the intestines as irritant purgatives. 
Copper salts enter the blood very slowly, and are elimi- 
nated by the saliva, bile, faeces, and urine. 



THE METALS. 2*] 

Preparations of Copper. 

Cupri Sulphas. 
Sulphate of Copper. 
Blue Vitriol, Bluestone. 

Made by heating copper with sulphuric acid, dis- 
solving, evaporating, and crystallizing. 

Externally it is used as an escharotic, and internally 
as a tonic and astringent. 

Symptoms of Poisoning. 

In cases of acute poisoning by blue vitriol, as much as 
| ss. or upwards, will produce the following symptoms, 
which come on in a few minutes : A strong metallic 
taste in the mouth ; nausea, and vomiting of bluish or 
greenish liquids ; a feeling of constriction in the throat ; 
a distended abdomen ; colicky pains in the stomach and 
bowels ; diarrhoea and tenesmus. These symptoms are 
fully developed in one or two hours : then follow rapid 
and difficult breathing ; small, quick pulse ; great thirst ; 
cold perspiration ; weakness, giddiness, stupor, coma, 
convulsions, and paralysis. Death may occur in a few 
hours, or delay several days. 

Treatment of Poisoning. 

Albumin, as white of egg, milk, wheat flour, should be 
given, and then, as the albuminate of copper is not en- 
tirely harmless, the stomach should be well washed out 
with plenty of warm water. Stomach-pump used if 
necessary. The chemical antidote is ferrocyanide of 
potassium, but with this, too, emesis should follow 
promptly. 

Dose (medicinal), gr. T V~i- 

Dose (emetic), gr. vi.-xii. 

Cupri Acetas. 
Acetate of Copper. 

Not often given internally, but used sometimes as 
a local application. Verdigris is an impure subacetate. 



28 MATERIA MEDIC A FOR NURSES. 

The acute forms of poisoning by these salts resemble the 
poisoning by the sulphate, and the treatment is the 
same. 

Copper poisoning, acute and chronic, may result from 
the use of dirty copper dishes and cooking utensils, and 
from cooking acid fruits in copper. Chronic poisoning 
is also caused by the inhalation of the fumes of copper, 
as in certain occupations, and by the adulteration of 
certain articles of food, as pickles, which are sometimes 
colored green with copper. Chronic poisoning presents 
the same symptoms as the acute form, but in a lesser 
degree, and death may result from exhaustion. 

Aluminium (Alum). 

Alum is known chemically as a double sulphate, being 
formed by the union of sulphate of potassium or ammo- 
nium with sulphate of aluminium, which is obtained 
from alum slate, or alum stone. It has a crystalline 
form and taste which is both acid and sweetish, and 
also astringent. It is soluble in water, but insoluble in 
alcohol. 

Physiological Actions. 

Alum is an astringent and styptic. In doses of 
3 i. it is an irritant but non-depressing emetic, and in 
large doses a purgative. Taken into the mouth, the 
flow of saliva is first increased by alum, and afterwards 
diminished, as it hardens the albumin of the secretions 
and contracts the capillaries. 

The same effect is shown on the mucous membrane of 
the stomach. Alum is absorbed into the blood, notwith- 
standing its power of coagulating albumin, and checks 
capillary hemorrhage by constricting the vessels. Alum 
should always be given alone, and it is to be remembered 
that it has a very injurious action on the teeth. 

Symptoms of Poisoning. 

In large doses alum produces gastro-enteritis, with 
frothing at the mouth. The treatment consists in pro- 



THE METALS. 29 

moting vomiting and washing out the stomach, giving 
hydrate of magnesia in large quantities, or a weak solu- 
tion of carbonate of ammonia at intervals. Death has 
been caused in eight hours in an adult by f ii. of alum. 

Preparations of Alum. 

Aluminis Sulphas. 
Sulphate of Alum. 

Should be given diluted and with a glass tube. Dose, 
gr. x -xx. 

Alumen Exsiccatum. 
Dried Alum. 

Alum which has been deprived of its water by heat, 
and powdered. Combined with alcohol (in which it is 
insoluble), in the proportion of 3 L-iv. to alcohol § v.-vi., 
it is used to harden the skin, as a preventive of bed-sores. 

Ferrum (Iron). 

All the salts and preparations of iron are made directly 
or indirectly from the metal. 

Physiological Actions. 

Iron is the most 'important of the mineral tonics, and 
may be more properly described as a food rather than 
as a medicine, being one of the most essential constitu- 
ents of the red blood corpuscles. It exists normally in 
the blood in the proportion of 1 part iron to 230 parts 
red corpuscles, and in a state of health enough iron is 
taken with various kinds of food, to supply the demand. 
Beef especially, as an article of diet, provides iron, as it 
contains 1 part iron to 194 parts red corpuscles. 

Iron has been called the great respiratory food. In 
the lungs it takes up oxygen from the inspired air, and 
carries it to all the tissues. No function of the body 
can be carried on without oxygen ; the muscular system 
especially is dependent for its perfect activity on the 



30 MATERIA MEDICA FOR NURSES. 

presence of oxygen, and muscular power is in direct 
proportion to the efficiency of the respirations. 

The feeling of tone and energy, both bodily and 
mental, which belongs to perfect health, comes from an 
ample supply of oxygen, and it is in this primary way 
that iron acts as a tonic ; stimulates and strengthens 
the heart, nerves, and muscles; raises the tem- 
perature of the body and increases the appetite. 

It is not absorbed by the unbroken skin, but on ex- 
posed tissue and mucous surfaces its action is astringent, 
coagulating the albumin of tissue and plasma, diminish- 
ing the circulation by compression of the vessels, and 
arresting hemorrhage. Iron is thus classed as a styptic 
or haemostatic. 

Taken internally there is an astringent taste, and the 
tongue and teeth are darkened by a sulphide which is 
deposited as a result of decomposition. If given in 
excess or on an empty stomach it decomposes the diges- 
tive fluid, and acts as an irritant and astringent upon 
the mucous membrane. 

The digestion or absorption of iron takes place partly 
in the stomach and partly in the intestines, and depends 
upon the presence, in normal quantities, of the gastric 
and intestinal juices. 

Iron has sometimes an irritant action on the bladder ; 
its astringency in the alimentary canal causes constipa- 
tion ; and it is said that it decreases the secretion of 
milk in nursing women. An excess of iron is eliminated 
from the system in almost every possible way, but prin- 
cipally by the faeces, which it colors black by forming a 
sulphide. 

The local irritant action of iron explains why it is 
always given well diluted and after meals. 

Incidental Effects. 

In administering a course of iron any one or more of 
the following symptoms may be noticed, indicating an 
excess in the system : Frontal headache, slight disturb- 
ances of the digestion, irritation of the stomach or of 
the bladder, a feeling of weight at the epigastrium, con- 



THE METALS. 3 1 

stipationj a feverish condition. An acne of the face 
and chest is sometimes produced by iron, and the reduced 
iron causes eructations of gas. 

It is very important to remember that all preparations 
of iron stain clothing, carpets, — in fact every thing 
touched, and that the stains are with difficulty removed. 
Silver spoons should never be used for iron, but if they 
have been used, the stain will come off if rubbed with 
aqua ammonia undiluted. Oxalic acid will take the 
stains out of muslin or linen. 



Preparations of Iron. 

( Saline Combinations. ) 

Tinctura Ferri Chloridi. 
Tr. of Chloride of Iron. 
Muriated Tincture of Iron. 

Made from the sesquichloride of iron, hydrochloric 
acid, and alcohol, and contains hydrochloric ether as a 
result of the reaction of the acid and alcohol. It is red- 
dish-yellow in color, and has peculiar properties. It is 
the most frequently used of all the preparations of iron. 
It is astringent, irritating, and somewhat corrosive. 
It has diuretic and antispasmodic qualities, owing 
probably to the ether, and is antiseptic by virtue of the 
chlorine and iron ; 'tonic, as are all iron preparations. 

Tr. of iron should never be given at the same time 
with tea, or with other medicines containing tannin, as 
an ink-like combination results. It should not be added 
to whiskey, but may be well given in milk, being dropped 
in at the moment when it is to be taken. Iron attacks 
the teeth, unless properly diluted, and should always be 
given through a glass tube. When the throat is gargled 
with iron, the teeth should be brushed after each appli- 
cation, or washed off with salt water. 

Dose, IT], ii.-xv. (TTj, x. = gtt. xxv.), half an hour after 
meals, in a tumblerful of water. 



32 MATERIA MEDIC A FOR NURSES. 

Mistura Ferri et Ammonias Acetatis. * 

Mixture of Acetate of Iron and Ammonia. 
Basham's Mixture. 

Composed of tr. of iron, dilute acetic acid, solution of 
acetate of ammonia, elixir of orange, syrup, and water. 
Dose, | ss.-i., well diluted. 

Syrupus Ferri Iodide. 
Syrup of Iodide of Iron. 

Has iodine, iron, and syrup, and exerts a special 
action on nutrition by means of the iodine. 

Dose, TTj, v.-xl. (TTj, x. = gtt. xiii.), largely diluted. 

Liquor Ferri Acetatis. 
Solution of Acetate of Iron. 

Dose, m ii-x. (tt[ x . = gtt. x.). 

Tinctura Ferri Acetatis. 
Tr. of Acetate of Iron. 

Contains solution of acetate of iron, alcohol, and acetic 
ether. Dose, TT[ xx- 3 i. 

Mistura Ferri Compositus. 
Compound Mixture of Iron. 
Griffith's Mixture. 

Contains sulphate of iron, carbonate of potassium, and 
myrrh. Dose, § i.-ii. 

Ferri et Quininae Citras. 
Citrate of Iron and Quinine. 

Contains 12 per cent, of quinine. Dose, gr. v. 

Ferri et Strychninae Citras. 
Citrate of Iron and Strychnine. 

Contains 1 per cent, of strychnine. Dose, gr. iii.-v. 



THE METALS. 33 

Ferri Iodidum Saccharatum. 
Saccharated Iodide of Iron. 

Dose, gr. i.-v. 

Ferri Lactas. 
Lactate of Iron. 

Dose, gr. i.-v. 

Liquor Ferri Subsulphatis. 

Monsel's Solution of Subsulphate of Iron. 

Sulphate of iron, sulphuric and nitric acids are con- 
stituents of Monsel's solution. It has a deep red color 
and the consistency of syrup. It is an active styptic, 
but it is rather uncertain in its action, sometimes causing 
severe sloughing, and is not much used. 

Blaud's Pills. 

Contain sulphate of iron and carbonate of potassium 
in equal parts. Dose, pil. i. 

(Metallic State.) 

Ferrum Reductum. 
Reduced Iron. 
Quevenne's Iron. 

A tasteless iron-gray powder. Dose, gr. ss.-ii. in pill. 

(Antidotes to Arsenic.) 

Ferri Oxidum Hydratum. 
Hydrated Sesquioxide of Iron. 

As an andidote to arsenic this preparation of iron 
must be fresh, and may be quickly prepared by adding to 
several ounces of the tr. ferri chlor. enough aqua ammo- 
nise or carbonate of sodium to form a precipitate, which 
will appear almost instantly. Continue adding the 
alkali until no more of the precipitate falls ; then turn it 
into a piece of muslin or a fine strainer and wash it well 
by letting cold water run freely through it, until all 
3 



34 MATERIA MEDICA FOR NURSES. 

traces of the soda or ammonia are removed. Stir up a 
tablespoonful of the precipitate in milk or water, and 
give it, repeating as often as necessary. It is harmless ; 
and about 8 grains of it are required to neutralize i grain 
of the poison. 

Ferri Oxidum Hydratum cum Magnesia. 
Hydrated Oxide of Iron with Magnesia. 

Made by precipitating the solution of the tersulphate of 
iron by magnesia. It is said to be the best antidote for 
arsenic. 

Monsel's solution or the tincture of the chloride of iron 
may be used instead of the tersulphate. 

Dialyzed Iron. 

An antidote to arsenic ; also given medicinally. It is 
said that it does not blacken the teeth nor constipate. 



Manganesium (Manganese). 

Manganese is found native in the form of the black 
oxide. 

Physiological Actions. 

Manganese is found in the human body associated 
with iron. They are found together in the blood, hair, 
and bile, the proportion in the blood being i part of 
manganese to 20 of iron. The preparations of manga- 
nese are gastro-intestinal irritants. In small doses they 
aid digestion and promote appetite. They enter 
the blood probably as albuminates. Used in excess 
they lower the heart action, diminish the pulse rate, and 
cause loss of muscular power and paralysis. 

The action of manganese on the tissues, blood, and 
excretory organs is not clearly defined. It is supposed 
that the salts are decomposed before being absorbed, ex- 
cept when in poisonous doses. 



THE METALS. 35 

Preparations of Manganese. 

Mangani Oxidum Nigrum. 
Black Oxide of Manganese. 

Once considered a haematinic, 1 but now believed to be 
inert. It has been used as an emmenagogue. Dose, gr. 
ii.-x., in pill or powder. 

Potassii Permanganas. 
Permanganate of Potash. 

Made from the black oxide of manganese, chlorate of 
potash, and a solution of caustic potash, by a very- 
elaborate chemical process. It has the form of dark- 
purple slender prisms, inodorous, with an astringent 
sweet taste ; soluble in 16 parts of water. 

Permanganate of potash in the pure state is irritant 
and caustic. In solution it is stimulating and heal- 
ing. In the latter form it gives out oxygen in the form 
of ozone, and changes into hydrated peroxide of man- 
ganese, losing its purple color and becoming brown. 
This change does not occur with the crystals. 

This oxidizing power gives it special attributes as an 
antiseptic, disinfectant, and deodorant. 

The strength necessary to destroy bacteria and prevent 
their reproduction is i in 150. It is rapid and thorough 
in action, is not poisonous in solution of ordinary 
strength, and the change of color shows when its power 
is exhausted. It is very expensive, and this is a draw- 
back to its use. 

Given internally, the dose, gr. ss.-ii., is freely diluted 
with distilled water ; or, if given in pellets, boiled or 
filtered water should be given with it to dilute it after 
being swallowed. It should be given on an empty 
stomach. 

Mangani Sulphas. 
Sulphate of Manganese. 

In full doses an emetic and cathartic, with action 
on the liver, as is shown by the bile discharged after 
purgative doses. Dose, gr. ii.-v. 

1 An agent that increases the number of red blood corpuscles. 



3 6 MATERIA ME DIC A FOR NURSES. 

Liquor Potassii Permanganatis. 
Solution of Permanganate of Potash. 

Condy's Fluid. — A solution containing gr. ii. to 3 i. 
used as a disinfectant and deodorant. 

Hydrargyrum (Mercury). 

Quicksilver. 

Mercury is obtained from cinnabar by roasting and 
distilling with lime. It is a silver-white metal, liquid, 
and giving off vapor at ordinary temperatures, and capa- 
ble of being entirely volatilized by heat. All the different 
preparations are derived directly or indirectly from the 
metal itself. 

Physiological Actions. 

In the metallic form mercury is inert, large amounts 
of the pure metal having been swallowed and discharged 
from the intestines without poisoning or injury ; but in 
the form of vapor, or any of its preparations, it is very 
readily absorbed by the pulmonary and other mucous 
membranes, by the alimentary canal, and by the skin 
and tissues, either whole or broken. The constitutional 
effects may be reached in any one or all of these ways. 

All mercurials are antiseptic and disinfectant. 

The local action of mercury in moderate strength, 
either externally or internally, is astringent, antiphlo- 
gistic, and stimulant. In large or concentrated doses 
it is irritant to the stomach and intestines, and in some 
forms is a locally acting purgative. 

In various pathological conditions of the system mer- 
cury exerts an influence as an alterative, through some 
power over nutrition which is not perfectly understood. 

Mercury is excreted by the saliva, perspiration, milk, 
urine, and bile. 

Sy7nptoms of Poisoning. 

The mildest evidences of over-doses of mercury are : 
slight fetor of the breath and soreness if the teeth are 






THE METALS. 37 

knocked together or struck ; a metallic taste next ap- 
pears. After this comes salivation, an abnormal amount 
of fluid being poured out from the salivary glands, and 
small ulcers appear on the lips, gums, and tongue. A 
feeling of constriction of the throat, which is found 
among the symptoms of acute poisoning, has been caused 
in some susceptible persons by a single medicinal dose of 
mercury. 

When its use is continued beyond this point salivation 
increases. The gums become swollen and spongy, and 
bleed easily. The tongue swells, sometimes protruding 
from the mouth. The teeth are loosened, and a dark 
line is seen at their upper margin. In some cases ulcera- 
tion of the soft parts and necrosis of the jaw-bones result. 
In pronounced chronic poisoning, in addition to these 
symptoms, there are abdominal pains, nausea, vomiting, 
and diarrhoea,, anaemia, emaciation and general weak- 
ness ; aching pains in the bones and joints ; loss of 
hair ; a trembling or shaking palsy ; and paralysis, with 
a brown tint of the skin. In some cases there is wrist- 
drop. Chronic poisoning may be caused indirectly by 
exposure to the metal or its fumes, as in various occupa- 
tions, and it may come on very suddenly. 

Acute poisoning will be described under corrosive 
sublimate. 

Preparations of Mercury. 

Hydrargyri Chloridum Corrosivum. 
Corrosive Sublimate ; Mercuric Chloride. 

Bichloride of Mercury.— In English books called 
the Perchloride. Made by subliming bisulphate of 
mercury with chloride of sodium. Soluble in 16 parts of 
cold water. It is the most powerful of all the mercurials, 
and one of the most active antiseptics and germicides 
known. A strength of i in 10,000 in solution destroys 
bacilli and micrococci. One in 1,000 destroys their 
spores. Solutions of 1 in 1,000 and 1 in 500 are the most 
reliable disinfectants to use in nursing contagious dis- 
eases, in purifying sick-rooms, or in providing aseptic 



38 MATERIA MEDIC A FOR NURSES. 

conditions for any purpose. White materials are stained 
yellow by bichloride of mercury, and it is not always 
desirable therefore as a disinfectant for clothing. 1 

The external use of bichloride of mercury as in 
dressing surgical and obstetrical cases, may produce 
symptoms of poisoning which must not be overlooked. 
Among the latter class of cases an eruption of small 
pimples appears about the buttocks and may extend 
down the limbs. Sore gums, fetid breath, and salivation 
may follow. The eruption should always be reported as 
soon as noticed. In chronic poisoning by this prepara- 
tion there is more tendency to abdominal pains, diarrhoea, 
and colic. 

Internally in small over-doses it causes nausea, burning 
in the stomach, colicky abdominal pain, and diarrhoea ; 
or, these symptoms may not be prominent and a sore 
ulcerated mouth may show the toxic action. In poison- 
ous doses it is a violent irritant and caustic, and the 
symptoms appear in a few moments — viz., a metallic 
taste, the mucous lining of the mouth sometimes glazed 
and white, vomiting of mucus and blood, dysenteric 
purging, tenesmus, and cramps, with fetid breath. Vio- 
lent abdominal pain is sometimes, not always, present. 
The urine is diminished, may contain blood and albu- 
min, may be suppressed. In the course of two or three 
hours there is collapse, with small, quick, irregular pulse, 
pinched, anxious face, cold extremities, syncope, convul- 
sions, coma, and death. 

The smallest fatal dose is not absolutely certain, but 
may be put at 3 to 5 grains. Death usually takes place 
in from 1 to 5 days, but may be earlier or later than 
this. On recovery the convalescence is long and tedious. 

The antidote is albumin, milk, gluten (flour), or, best 
of all, the white of egg, in proportion of 1 egg to 4 grains 
of the poison. More than this is said to redissolve the 
mercury. 

Vomiting should be promptly induced and actively kept 
up for a time after taking the antidote. 

1 For this purpose the solution of salt and sulphate of zinc is better. 
See zinc. 



THE METALS. 39 

Dose, gr. -gV'sVj we U diluted and given after meals 
All other non-purgative preparations are, as a rule, taken 
after meals also. 

Hydrargyri Chloridum Mite. 
Mild Chloride of Mercury. 

Calomel. — Made by subliming sulphate of mercury 
and chloride of sodium. A white, insoluble powder, 
used as a cathartic and indirect cholagogue. 1 

It increases the amount of bile evacuated from the in- 
testines without directly increasing the amount secreted 
by the liver. In the ordinary routine of digestion part of 
the bile in the intestines is re-absorbed and carried back 
to the liver ; but by the action of calomel this is all ex- 
pelled from the body, the result being that the next 
quantity secreted must all be newly formed, out of fresh 
materials. 

Salivation occurs more frequently from the use of 
calomel than from other mercurials except blue pill, and 
it has an insidious harmful effect on the teeth, tending to 
retract the gums and expose the unprotected roots. Be- 
ing tasteless and insoluble, it is best given dry on the 
tongue, with some water after it. It is slow in its action, 
requiring from 8 to 12 hours if given alone. Salty food 
should not be taken after calomel, as alkaline chlorides 
change it into bichloride. Acids also are often forbid- 
den, though this is not now considered very important. 

Children bear relatively larger doses of calomel than do 
adults. Dose, gr. T^-gr. x. 

Massa Hydrargyri. 
Blue Mass. 

Made by combining mercury in the metallic state with 
honey or other inert substances. It contains one third its 
weight of the metal, and is used, like calomel, as a purga- 
tive, but is milder. Each pill contains usually from 3 to 
5 grains of the mass, equalling gr. i.-if of metal. Dose, 
gr- i -x. 

1 A purgative which acts also on the liver. 



40 MATERIA ME DIC A FOR NURSES. 

Hydrargyrum cum Creta. 
Mercury with Chalk. 

A gray powder, similar in its properties and strength, 
to blue mass. It may be placed dry on the tongue 
or mixed with glycerine. Dose, gr. i.-x. The mercurial 
purgatives are abused by numbers of persons who 
prescribe for themselves. They should never be taken 
without authority, and it is also to be remembered that 
many quack purgative medicines, " liver pills," etc., con- 
tain mercury in uncertain quantities, and are harmful. 

Unguentum Hydrargyri. 
Mercurial Ointment. 

Composed of compound tr. of benzoin and 50 per 
cent, of mercury. 

Mercury, besides being given internally, is used in the 
form of vapor baths and inunctions. There are many 
preparations, and with all of them constitutional symp- 
toms are likely to appear, and must always be watched for. 

It is of great importance that the diet of persons 
taking mercury should be ample and nutritious. 

Mercurial ointments should be rubbed in with a piece of 
flannel ; nurses have been salivated by using their hands 
for this purpose. 

Arsenium (Arsenic). 

Metallic arsenic is inert, and is not used in medicine. 
Acidum Arseniosum. 
Arsenious Acid. 
White Arsenic ; Arsenic. 

Obtained principally as a secondary product in the 
roasting of cobalt ores. It is not a true acid, but an 
anhydride, or acid deprived of its water. All the 
preparations of arsenic are derived from white arsenic. 

Physiological Actions. 

Arsenic in concentrated form applied to the tissues 
causes inflammation, followed by ulceration and plough- 
ing. It has therefore been used as an escharotic, 1 but 

1 Any substance whose action produces sloughing. 



THE METALS. 4 1 

its action is very painful and is attended with danger, 
as arsenic is readily absorbed from broken ckin, ulcers, 
and mucous membrane, unless there is enough inflamma- 
tion to throw it off ; it being understood that when 
an inflammatory process is going on, the absorptive 
capacity of that part is checked. 

In the stomach in medicinal doses arsenic does not 
combine with the albuminous contents of the organ, but 
remains unchanged and acts directly on the mucous 
membrane, stimulating the nerves and vessels, causing a 
sense of heat and hunger, and promoting the gastric 
functions. 

Arsenic enters all organs and tissues, increases tissue 
changes and the vital activity of the whole system. It 
does not combine with the tissues, and is excreted 
chiefly by the urine, and also by the skin, liver, and 
intestines. Arsenic is therefore, in medicinal doses, a 
stomachic and general tonic, increasing the appetite 
and improving digestion and general nutrition. 

It stimulates the secretions, peristaltic action, the brain, 
heart, and respiratory centre. 

Symptoms of Poisoning. 

In giving arsenic, the first signs which indicate over- 
dosing are : a slight pufnness about the eyelids, without 
redness, and noticeable first in the early morning, dis- 
appearing later ; an itching of the eyelids ; tingling or 
itching of the fingers, abdominal pain or soreness. 
Increasing symptoms of over-dosing are : a metallic 
taste, nausea, vomiting, diarrhoea, and sometimes dysen- 
teric stools, with tenesmus ; an irritable and feeble heart 
action ; palpitations and oppressed breathing ; eczema 
and other skin eruptions ; trembling and stiffness of the 
joints ; and albuminuria. 

In acute poisoning the symptoms are of two varieties, 
gastro-intestinal and cerebral. The former is much more 
common, and is marked by a burning pain at the epigas- 
trium, radiating over the abdomen ; violent and uncon- 
trollable vomiting of matter, first mucous, then bilious, 
and finally serous ; intense thirst and dryness of the 



42 MATERIA MEDIC A FOR NURSES. 

mouth and throat ; stools bloody and offensive, some- 
times involuntary ; strangury ; sometimes bloody urine, 
or suppression ; great restlessness and agitation ; dysp- 
noea ; a rapid, weak, intermittent pulse ; cold breath ; 
shrunken face ; cold and clammy skin, and final col- 
lapse, consciousness being retained until death occurs. 
In the cerebral form there is sudden and deep insensi- 
bility, ending in death, without intestinal symptoms. 
Occasionally there is a combination of both sets of 
symptoms ; also they may vary according to the form 
and dose in which the poison has been taken. The time 
in which they come on is usually from half an hour to an 
hour after taking the poison, and death has occurred in 
a few hours, but the average length of time is about 
twenty-five. It often happens that recovery is made 
from the first effects, with death from exhaustion or 
secondary causes many days, or even weeks, after. 

The fatal dose for an adult may be put at from 2 to 4 
grains. 

Treatment of Poisoning. 

In treating poisoning by arsenic, if vomiting has not 
already been caused by the poison, emetics should be 
given : a tablespoonful of mustard in a glass of warm 
water, followed by large quantities of mucilaginous and 
albuminous drinks, such as flaxseed tea, milk, with white 
of egg, etc. The antidotes, hydrated sesquioxide of 
iron and hydrated magnesia, have been described under 
iron and may be given in water, a tablespoonful at a 
time, every few minutes while necessary. Castor-oil 
should be given to clear the bowels. If the poison has 
been taken in solution the antidotes will precipitate it in 
an insoluble form, but no confidence can be placed in 
them if the powder has been taken, as rat-poison (often 
used in suicidal cases). The early and complete re- 
moval of the poison by emetics and purgatives is then 
the only real hope. The urine must be watched, as 
suppression may occur, and, while the patient lives, a 
daily specimen saved for examination. 



THE METALS. 43 

Arsenic is not accumulative, and is an irritant, not 
a corrosive poison. After death the stomach and in- 
testines are found to be deeply reddened and inflamed, 
but not ulcerated. The post-mortem appearances, as 
well as many of the symptoms, resemble those of cholera 
very strongly. Chronic poisoning is caused by the in- 
halation of arsenical fumes, by the use of wall-papers 
and clothing dyed with materials containing arsenic, and 
by eating adulterated candy and other articles of food. 

Preparations of Arsenic. 

Acidum Arseniosum. 
Arsenious Acid. 

Dose, gr.-5V~T 1 o> well diluted and given after meals. 

Liquor Acidi Arseniosi. 
Solution of Arsenious Acid. 

Contains arsenious acid i part in ioo, and hydrochloric 
acid i part in 200. 

Dose, TT], ii.-x. (TTt x. = gtt. x.), well diluted and given 
after meals. 

Liquor Potassii Arsenitis. 
Solution of Arseniate of Potash. 

Fowler's Solution of Arsenic. — Contains tr, of 
lavender and arsenious acid and bicarbonate of potas- 
sium, 1 part of each in 100. Five minims represent 

Dose, TU n.-x. (TT[ x. = gtt. x.), well diluted and given 
soon after meals. 

Liquor Sodii Arsenitis. 
Solution of Arseniate of Soda. 

Pearson's Solution. — A much weaker solution than 
Fowler's, containing in § i. gr. iv. of the arseniate of 
soda. 

Dose, "HI ii.-xv. (TTJ, x. = gtt. x.) ; after meals. 



44 MATERIA MEDICA FOR NURSES. 

Arsenii Iodidum. 
Iodide of Arsenic. 

Dose, gr. sWo- 

Cupri Arsenis. 
Paris Green. 

Is not used medicinally, but is often taken as a means 
of suicide. 

Donovan's Solution. — Contains iodide of arsenic 
and red iodine of mercury, but is now seldom used. 

It may be repeated in conclusion that all preparations 
of arsenic should be given well diluted, and soon after 
meals, to avoid the local irritant action on the stomach ; 
and that it is necessary to keep close watch for the con- 
stitutional symptoms, which may at first be so unobtrusive 
as to escape notice. 

Antimonium (Antimony). 

The metal itself (stibium) is not officinal, all prepara- 
tions being derived from black antimony, which is 
obtained from siliceous matter, purified and powdered. 

Antimonii et Potassii Tartras. 
Tartrate of Antimony and Potash. 

Tartar Emetic. — Made by boiling cream of tartar 
and water with oxide of antimony. 

Tartar emetic, applied to the skin, is a strong counter 
irritant, and excites an eruption closely resembling tha 
of smallpox, viz., small papules, becoming vesicular an\ 
finally pustular. It is now but little used in this way 
Internally it is irritant, and, as an emetic its action i 
partly direct — that is, acting immediately on the walls oi 
the stomach, and partly indirect, or acting on the nerve- 
centre in the medulla which controls vomiting. Tartai 
emetic causes nausea and depression both before and 
after the act of vomiting, and is therefore not well 
suited to cases where rapid action with as little depres*. 
sion as possible is required, as in poisoning. 



THE METALS. 45 

In small continued doses the local action of tartar 
emetic is apt to produce loss of appetite, nausea, diar- 
rhoea, and pain. In the tissues antimony has an alter- 
ative action, the special results being an increase of the 
waste products of the body, with a lessening of oxygena- 
tion, and fatty degeneration of the organs. 

Tartar emetic depresses the circulation even in small 
doses, the first effect visible after a therapeutic dose 
being a diminution of the pulse and increase of perspi- 
ration. 

With a continuance of the medicine the pulse becomes 
weakened, soft, and compressible, infrequent and irreg- 
ular, and fainting may occur. Respiration is weakened, 
inspiration being shortened, and expiration lengthened. 

The nervous system is depressed, a feeling of languor, 
sleepiness, and lassitude being produced by a moderate 
dose. It affects the muscular system so powerfully that 
before chloroform came into use tartar emetic was em- 
ployed to produce muscular relaxation in the reduction 
of dislocations, etc., and the depressed state so brought 
about lasted for six or eight days in spite of heart stimu- 
lants. 

Emetic doses cause great muscular weakness, tremors, 
and aching of the muscles, loss of power to stand, with 
free perspiration and an increase of saliva. 

Antimony is excreted by all the mucous surfaces, the 
liver, kidneys, and skin. 

Its excretion by the bile shows it to be a hepatic 
Stimulant ; in passing through the kidneys it acts as a 
diuretic, and through the skin as a diaphoretic. 

The characteristic pustular eruption is sometimes 
caused by its internal use. 

Symptoms of Poisonifig. 

The symptoms of poisoning are very like those of the 
collapse of cholera, viz. : shrunken features, cold surface 
and breath ; great epigastric pain, vomiting, and purging ; 
small, rapid, soft, and irregular pulse ; cyanosis ; syn- 
cope ; cramps of the lower extremities ; insensibility to 



46 MATERIA MEDICA FOR NURSES. 

stimulants ; intense prostration ; delirium ; tetanic spasms 
in some cases, or aphonia. 

The quantity of tartar emetic which will destroy life is 
not definitely known. The smallest fatal dose recorded 
is J of a grain in the case of a child ; gr. ii. has caused 
death in an adult, while doses have been recovered 
from, ranging from gr. xx. to § i. It is probable that, 
under ordinary circumstances favoring the action of the 
poison, gr. x. or xv. would destroy life, if taken at once, 
or a smaller quantity, if divided. The symptoms come 
on rapidly, and death may occur in a few hours, or days, 
or may be delayed for several weeks. 

Treatment of Poisoning. 

The antidote is tannic acid ; or substances containing 
it, as strong tea. Opium, and alcoholic stimulants, with 
demulcent drinks, are given. 

Dose of tartar emetic, gr. j-^-i., diluted. 

Vinum Antimonii. 
Wine of Antimony. 

Contains of tartar emetic gr. ii. to § i. 
This preparation decomposes on being kept, and a 
fungoid growth takes place in it which unfits it for use. 
Dose, TU v. (TTt x. = gtt. xii.)-3 ss. 

Syrupus Scillae Compositus. 
Compound Syrup of Squill. 

Contains squill, senega, phosphate of lime, and dilute 
alcohol, with tartar emetic, about gr. {to § i. Syrup of 
squill is sometimes used as a domestic remedy for chil- 
dren, without a physician's order, and as tartar emetic is 
not a safe medicine for children, its unauthorized use has 
sometimes had fatal effects, and should always be strongly 
discouraged. 

Bismuthum (Bismuth.) 

A crystalline metal, impure in its crude state, and con- 
taining arsenic as one of the impurities. It goes through 
various chemical processes by way of purification. 



NON-METALLIC ELEMENTS. 47 

Physiological Actions. 

Externally and internally bismuth acts as a mild seda- 
tive and astringent. It is useful as a dry application 
in the first stages of bed-sores, as a dressing for burns and 
blisters, and may be satisfactorily used on small fresh 
wounds. It is given internally as an astringent, and in 
large quantities colors the faeces black or dark-gray. 

Bismuthi Subnitras. 
Subnitrate of Bismuth. 

A heavy white powder, odorless and almost tasteless, 
insoluble in water. The easiest way to give it is mixed 
in a little glycerine and diluted with milk or water ; or 
it may be given in wine. 

Dose, gr. v.- 3 i. 

NON-METALLIC ELEMENTS. 

Phosphor (Phosphorus). 

A non-metallic element made from bones, by treating 
bone-ash with sulphuric acid and water. It is a semi- 
transparent, almost colorless, wax-like solid, with a 
peculiar garlic odor : it is luminous in the dark, is in- 
soluble in water, and soluble in ether and in oils. 

Phosphorus is a constituent of the most important 
tissues of the body, especially of the nervous system, 
where it exists as phosphorized fats. In the bones it is 
present as phosphate of calcium, magnesium, and sodium. 
It is contained in various articles of food, especially 
in fish and vegetables. 

Physiological Actiotis. 

In small doses phosphorus acts as a tonic and alter- 
ative, and stimulates the nutritive processes, especially in 
the case of the nervous and bony tissues. Given for a 
considerable length of time in small doses it affects the 
structure of bone, and makes the spongy portion firm and 
compact. The heart is stimulated by medicinal doses of 
phosphorus, and the temperature slightly raised. 



48 MATERIA MEDICA FOR NURSES. 

Full doses given for a long time disturb the stomach, 
producing eructations of gas (phosphide of hydrogen), 
and depress the heart. Perspiration and urine are in- 
creased by phosphorus, and the latter becomes reddish 
and has the odor of violets. 

Symptoms of Poisoning. 

Phosphorus is an irritant poison, and the symptoms 
vary somewhat according to the state in which it is taken, 
appearing more quickly after taking a solution in oil, or 
the paste used as a vermin killer, than after match heads 
or ordinary phosphorus have been used. In the latter 
case the symptoms do not come on at once ; some hours 
usually — sometimes one or two days — intervening before 
they show themselves. Then epigastric pain and burning 
begin, with a burning sensation in the throat, a taste of 
garlic in the mouth, and an odor of garlic to the breath ; 
great thirst, nausea, and vomiting. During the first 
eight or ten hours the vomited matters have a garlic odor 
and are luminous in the dark, and if purging occurs, the 
faecal matters are sometimes luminous, as is also the urine. 
Vomiting sometimes continues through the whole of the 
attack, but usually stops about the second or third day. 
Jaundice is a characteristic but not an invariable symp- 
tom. It appears from the third to the fifth day, and with 
it vomiting may reappear, exuded blood giving a 
peculiar appearance which is described as " coffee- 
ground." There is great prostration, with a small, 
frequent, almost imperceptible pulse, and cold skin. The 
mind may remain clear, or there may be noisy delirium. 
Sometimes convulsions occur, or paralysis. Death may 
take place suddenly from collapse and paralysis of the 
heart, but more commonly the patient dies comatose 
from gradual failure of respiration and circulation. The 
time at which death occurs varies from a few hours to 
several weeks, the average time being several days or a 
week. 

The fatal dose is stated to be between gr. } and ii., 
though it may vary 'according to circumstances, and 
large quantities have been recovered from. 






N ON METALLIC ELEMENTS. 49 

Treatment of JPoisomng. 

The chemical antidote is the crude French acid 
turpentine, which is given in doses of 3 ss. every fifteen 
minutes. After the poison has entered the blood there 
is no known antidote, and therefore, emetics and pur- 
gatives are of the greatest importance. Sulphate of cop- 
per is the emetic used, and forms an insoluble compound, 
phosphide of copper. It is given in dilute solution, gr. 
ii. at a time, every five minutes until vomiting is caused, 
and after that in small doses, gr. J, every twenty minutes 
as long as ordered. Hydrated magnesia may be used as 
a purgative. Mucilaginous and albuminous drinks are 
given, and all oils and fats carefully avoided, both in 
medicine and nourishment, as they dissolve phosphorus 
and hasten its absorption. 

Chronic phosphorus poisoning is found among art- 
isans who are exposed to the fumes, and is especially 
characterized by necrosis of the jaw. This form of 
poisoning is not as common now, since improved ways 
of making matches have been introduced, as it once was. 

Preparations of Phosphorus. 

Oleum Phosphoratum. 
Phosphorated Oil. 

Contains stronger ether, oil of almond, with phospho- 
rus in a strength of 1 in 100. One minim equals gr. y^ T 
of phosphorus. 

Dose, TTi i.-iii. ( tt[ x . = gtt xv). 

Pilulae Phosphori. 
Pills of Phosphorus. 

Each contains gr. T J ¥ of phosphorus. 

Zinci Phosphidum. 
Phosphide of Zinc. 

Gr. i. contains nearly gr. J of phosphorus. It is an 
irritant preparation. Dose, gr. 3V— sV- 
4 



50 MATERIA MEDICA FOR NURSES. 



Hypophosphis. 




x.- 3 ss. 

Syrupus Hypophosphitum. 
Syrup of Hypophosphites. 

Contains hypophosphite of lime, about gr. iii. to 3 i., 
and of soda and potash each about gr. i. to 3 i., with 
citric acid, spirits of lemon, and sugar. 

Dose, 3 i.~ 3 ii., diluted. 

Chlorum (Chlorine). 

Chlorine is a greenish-yellow gas, belonging to the 
halogen group of elements. The title " halogen " is 
derived from the Greek word meaning sea, and is so 
given because the most important members of the group 
are obtained directly or indirectly from the ocean — viz. : 
chlorine, obtained from sea-salt ; bromine, from sea- 
water ; and iodine, from sea- weed. 

Chlorine itself is not officinal, but is represented in 
medicine by several of its compounds ; also by hydro- 
chloric acid and chlorinated lime, by which it is fur- 
nished. Chlorine is irrespirable, and of strong penetrating 
odor. It is soluble in water, in the proportion of two 
parts gas to one part water. If inhaled in any quantity 
it irritates the lining of the air-passages, causes spasm of 
the glottis, and narcotizes the brain. 

It is a most powerful disinfectant, antiseptic, and 
deodorant, its great activity in these respects being due 
to its affinity for hydrogen, by which it decomposes com- 
pounds containing hydrogen, and sets oxygen free in its 
most active state, as ozone. It is not used in disinfect- 
ing clothing, as it destroys the color and texture of 
fabrics, nor the person, as it cannot be breathed in a 
strength sufficient to destroy germs. For disinfecting 
rooms it may be prepared as follows : Mix equal parts 



NON-METALLIC ELEMENTS. 5 I 

of common salt and black oxide of manganese. To a 
tablespoonful of this powder, in a saucer, add a table- 
spoonful ( 3 ss.) of strong sulphuric acid diluted one 
third with water. In cold weather the saucer should be 
heated. This will produce enough chlorine to disinfect 
a room thirty-two feet square. 

Calx Chlorata. 
Chlorinated Lime. 

Made by the action of chlorine on slaked lime, con- 
taining 25 per cent, chlorine. Its action as a disinfect- 
ant is that of chlorine, and when so used it should be 
perfectly fresh or it is valueless. To test it, dissolve a 
little in water ; if the solution is clear, it is good, but if 
it has lost its chlorine the solution will be turbid and 
milky. 

Liquor Sodae Chloratae. 
Solution of Chlorinated Soda. 
Labarraque's Solution. 

Contains hypochlorite and chloride of sodium. A 
greenish-yellow liquid, with sharp salty taste and very 
slight odor of chlorine. It is a good preparation for 
cleansing purposes in sick-rooms, wards, etc., in weak 
solution. In full strength it removes stains from glass. 
Medicine droppers, douche nozzles, and other small 
articles which are hard to clean may be soaked in it 
until the stains come away. It discolors plain pine 
boards, turning them yellow. It is sometimes given 
internally, in half a tumblerful of sweetened milk or 
water. 

The antidote, in case of poisoning by any of the 
chlorine compounds, is albumin ; white of egg, milk, 
and flour. Dose, 3 ss.— ii. 

Bromum (Bromine). 

A liquid element obtained from sea-water and from 
certain mineral springs. A dark, brownish-red, very 



52 MATERIA MEDIC A FOR NURSES. 

volatile liquid, of strong and suffocating odor. When 
brought into contact with organic matter it oxidizes and 
destroys it with great rapidity. Its local action is, there- 
fore, powerfully irritant and escharotic. It is also a 
deodorant and antiseptic. It is never given inter- 
nally, alone, but has been used as a caustic, and the 
vapor has been used medicinally. 

Preparations of Bromine. 

Potassii Bromidum. 
Bromide of Potassium. 

Prepared by adding a solution of pure carbonate of 
potash to a solution of bromide of iron, filtering, and 
evaporating. Colorless crystals, soluble in i-f$ parts 
water. 

Physiological Actions. 

Bromide of potash lessens cerebral activity, and the 
tendency to " emotionalism " ; diminishes the sensibility 
and irritability of the mind in various nervous states ; 
such, for instance, as result from excessive mental strain, 
anxiety, or intellectual work ; and produces a condition 
of anaemia of the brain such as is found in natural sleep. 
It is thus an indirect hypnotic, not acting like opium, 
or chloral, but inducing sleep by bringing about a physio- 
logical condition favorable to its advent. Bromide of 
potash is depressing to the heart and respirations, both 
being slowed and weakened by its action. The spinal 
centres, spinal nerves, and the muscles are all depressed, 
and the temperature somewhat lowered, though not to 
any marked extent. Bromide of potassium contains 66 
per cent, of bromine. 

Dose, gr. x.-lx. 

Ammonii Bromidum. 
Bromide of Ammonium. 

Prepared by precipitating the freshly made solution of 
bromide of iron with aqua ammoniae. The salt remain- 



NON-METALLIC ELEMENTS. 53 

ing in solution is crystallized and powdered. It is soluble 
in \\ parts of water. The effects and uses of bromide 
of ammonia are very like those of the bromide of potash, 
and it is said to be, in addition, slightly stimulating. 
It is not much used. 
Dose, gr. x.-lx. 

Sodii Bromidum. 
Bromide of Sodium. 

Colorless crystals, soluble in i T 2 o parts of water, and 
containing 78 per cent, of bromine. It resembles bro- 
mide of potash, and has very much the same qualities. 
It is considered less depressing than bromide of potash, 
and the least toxic of all the bromide preparations. 
There is a variety of opinions as to its hypnotic power 
compared with bromide of potash. 

Dose, 3 ss.-ii. 

Lithii Bromidum. 
Bromide of Lithium. 

A granular, very soluble salt, containing 92 per cent, 
of bromine. In addition to the hypnotic power of the 
bromides in general it is said to have some tonic and 
diuretic action. 

Dose, gr. v.-xx. 

Incidental Effects. 

In giving a course of the bromides it is very essential 
that the state of the digestion and of the bowels be care- 
fully watched, and the latter strictly regulated, for the 
accumulation of an excess of bromine in the system 
causes a series of symptoms known as " bromism." The 
first is usually a salty taste in the mouth, with salivation 
and fetid breath. Next come drowsiness, heaviness, and 
sluggishness of intellect, loss of memory, partial aphasia, 
depressed spirits, a staggering gait, dull, listless expres- 
sion, sluggish pupils, and sometimes an infrequency of 
winking. 



54 MATERIA MEDIC A FOR NURSES. 

One of the marked features of bromism is the appear- 
ance of eruptions of the skin, in great variety, and of 
varying severity. All manner of skin lesions have been 
described, as resulting from the use of bromine, even to 
one resembling that of smallpox. The most common is 
a simple acne or eruption of pimples. It sometimes 
occurs early, or after the use of small doses, yet is not 
always among the first symptoms. 

The bromides are excreted by the kidneys chiefly, 
also by the salivary and mammary glands, the skin, and 
all mucous surfaces. They are rapidly diffused, appear- 
ing in the secretions a few moments after being taken. 

Iodum (Iodine). 

Iodine is a non-metallic element of bluish color, de- 
rived chiefly from the ashes of sea-weeds ; not readily 
soluble in water ; soluble in ether, alcohol, and glycerine. 
It is never given internally in crude form. 

Physiological Actions. 

Applied externally iodine is an irritant and vesicant, 
and stains the skin yellow, or, in repeated applications, 
deep brown. It causes some pain, with a feeling of 
warmth, and desquamation may follow its use. It is 
absorbed into the blood partly through the skin and 
partly in the form of vapor. 

The vapor of iodine, like that of chlorine but in a 
feebler degree, decomposes sulphuretted and phosphu- 
retted compounds, and is, therefore, antiseptic and 
disinfectant. Internally iodine excites a sensation of 
heat and burning in the stomach. In sufficient quantity 
it is an irritant poison, causing inflammation of the lining 
of the stomach, severe pain in the abdomen, vomiting, 
and purging. The matters vomited have a yellow color, 
except when farinaceous food has been taken ; in this 
case they are blue or purplish. The amount of iodine 
necessary to produce toxic symptoms varies with consti- 
tutional peculiarities and with the kind and amount of 
food in the stomach. Death has been caused in twenty- 



NON-METALLIC ELEMENTS. 55 

four hours by 3 i. The antidote is starch or flour stirred 
up in water, and emetics should be given afterwards. 

Iodine is rapidly excreted, appearing in tne urine, the 
perspiration, saliva, bile, milk, and mucous secretions, 
especially of the air-passages. 

Preparations of Iodine. 

Potassii Iodidum. 
Iodide of Potassium. 

Made by dissolving iodine in liquor potassae, evapora- 
ting, and treating the residue with wood charcoal. 

Iodide of potash is extremely diffusible and enters the 
blood with great rapidity. It acts in a general way as a 
tonic and Stimulant to nutrition, accelerates tissue- 
changes, and increases the excretion of waste products. 
It has some slight diuretic action, and has the power of 
dislodging from the tissues various poisonous metallic 
substances, notably lead and mercury. 

The lymphatic glands are reduced in size by iodide of 
potash, and, like mercury, it has over some forms of dis- 
ease a marked and positive influence, not thoroughly 
explainable. Its action in these cases is called " specific " 
or " alterative." 

Incide?ital Effects. 

In giving any of the iodides, and especially the iodide 
of potash, the peculiar set of symptoms known as 
" iodism " must be carefully watched for. There is first 
an inflammation of the mucous membrane of the head 
resembling acute coryza, or catarrh ; running at the eyes 
and nose, salivation, swelling of the eyelids, sneezing, 
and frontal headache ; sore-throat, hoarseness, and trou- 
ble in swallowing, with a feeling of general wretchedness, 
and rise in temperature. 

There are also several varieties of eruptions which may 
appear, said to be more likely to occur in the case of 
patients with diseased kidneys. The most common is an 



56 MATERIA MEDICA FOR NURSES. 

eruption of acne on the face, shoulders, and thighs, and 
eczema is also frequent. 

Debility and pains in the joints are sometimes noticed, 
and in some cases digestive disturbances result, with 
nausea and diarrhoea. 

The solution of i in i (Tit i. = g r . i.), is best given in 
milk ; or it may be given in cinnamon water, or the 
compound syrup of sarsaparilla, to disguise the unpleas- 
ant taste. It is often ordered with bichloride of mercury, 
and they may be given together, but if it is not ordered 
in combination it should never be added to any other 
medicine, but given alone. 

By largely diluting it and giving it on an empty stom- 
ach, symptoms of iodism are in a measure avoided. 

Dose, gr. v.- 3 i. 

Liquor Iodi Compositus. 

Lugol's Compound Solution of Iodine. 

Composed of iodine and iodide of potash. Twenty 
minims contain gr. i. of iodine. 

Dose, fll v.-xv. {y\ x. = gtt. x.), well diluted. 

Sodii Iodidum. Dose, gr. v.-xx. 
Zinci Iodidum. Dose, gr. ss.-ii. 
Arsenii Iodidum. Dose, gr. ^VrV 
Ammonii Iodidum. Dose, gr. iii.-v. 

Tinctura Iodi. 
Tincture of Iodine. 

Contains 8 parts iodine and 92 parts alcohol. It is 
used externally as a counter-irritant ; applied with a 
camel's-hair brush, and in one or more coats as ordered. 
Each coat must dry separately. It cannot be diluted 
with water, as the iodine precipitates in water. If ex- 
treme burning follows the application and it is desirable 
to wash it off, alcohol, or ether, or a solution of iodide 
of potash will remove it. 



NON-METALLIC ELEMENTS. $7 

Unguentum Iodi. 
Iodine Ointment. 

Contains 4 parts in 100 of iodine, with one part of 
iodide of potash, and benzoinated lard. 

Iodoformum. 
Iodoform. 

Iodide of Formyl. — Iodoform is made by heating 
iodine with carbonate of potassium, alcohol, and water, 
and allowing the crystalline deposit to settle. It con- 
sists of small, bright-yellow, lustrous crystalline scales, 
with a very strong and clinging odor, and sweetish taste. 
It contains about 97 per cent, of iodine, and is freely 
soluble in oils, ether, and chloroform. 

Iodoform was discovered in 1822, but was not used 
for some years. At various times since then its qualities 
have been referred to in medical articles, and within the 
last few years it has become very popular as an an- 
tiseptic in surgical dressings, — so much so that its use 
has been carried to excess and its reputation greatly 
exaggerated. Various cases of poisoning had the effect 
of checking its too lavish use, and its limitations as well 
as its powers are now more clearly known. 

It is no longer considered one of the most active 
germicides, as was claimed for a time, yet it has proper- 
ties sufficient to give it a secure place in surgery. It 
prevents or arrests decomposition, promotes union and 
cicatrization in wounds, and is a deodorizer. It is not 
irritating, but acts rather as a local anodyne. In a 
wound treated with iodoform the secretion is lessened, 
and is serous rather than purulent in character. In 
cases of poisoning by absorption through a wounded 
surface, the following symptoms may occur : 

Rise of temperature as high as 104 F., or higher. 
This may be the only symptom ; or with it there may be 
headache, a rapid and compressible pulse, and loss of 
appetite, the symptoms going off as soon as the iodoform 
is discontinued. Iodine is found in the urine in iodo- 
form poisoning. More serious effects are : a grave de- 



58 MATERIA MEDIC A FOR NURSES. 

pression of the system, and anxious melancholia : a 
restless mental condition, with very weak and rapid 
pulse, perhaps reaching 180 ; drowsiness, delirium, and 
collapse. Death sometimes occurs quickly, even though 
the application be stopped. The amount capable of 
causing fatal poisoning has been recorded as varying 
from 500 grains upwards. In using iodoform the extent 
of exposed surface through which absorption may take 
place is of more importance than the actual amount^ ap- 
plied, which may not all be absorbed. 

Iodoform is sometimes given internally, in pill or 
capsule. Dose, gr. i.-ii. 

Unguentum Iodoformum. 
Iodoform Ointment. 

Iodoform 10 parts, and benzoinated lard 90 parts. 

Iodol. 

Iodol is a new substance which has been chemically 
produced in the attempt to make an equivalent for 
iodoform, which should have its qualities without the 
unpleasant odor. It is obtained by the action of iodine 
on certain constituents of mineral oil, and contains about 
85 per cent, iodine. It is a yellowish-brown powder, 
which darkens on exposure to light. It is odorless, 
soluble in alcohol, ether, and chloroform ; insoluble in 
water. It is said to be as efficiently antiseptic and 
disinfectant as iodoform, having the same deodorant 
and anaesthetic properties, but it is not much used. 

Iodized Phenol. 

A mixture of iodine and carbolic acid, for external use. 

Sulphur (Brimstone). 

Sulphur is found native in volcanic districts as crude 
sulphur, and in combination with metals, as sulphides. 

Physiological Actions. 

Sulphur is used externally for its action on the skin. 
It has no local action of its own, but by contact with the 



NON-METALLIC ELEMENTS. 59 

products of the skin it changes into sulphuretted hydro- 
gen and sulphides, which are active substances. In this 
form it is a vascular stimulant, a nerve sedative, a 
stimulant to the skin, and a diaphoretic. 

Taken internally it acts as a laxative, increasing peri- 
stalsis, and it has also probably some power of influencing 
nutrition. 

If taken for a long time it impairs the blood and causes 
emaciation, anaemia, trembling, and debility. It forms 
sulphuretted hydrogen in the intestines, giving an un- 
pleasant odor to the faeces, and the same disagreeable 
odor is imparted to the perspiration, by the excretion of 
sulphur through the skin. Silver jewelry worn by a pa- 
tient taking sulphur becomes discolored by the excretions 
of the skin. 

Preparations of Sulphur. 

Sulphur Sublimatum. 
Sublimed Sulphur. 

Flowers of Sulphur. — Prepared from crude sulphur 
(which compressed into molds forms the roll sulphur used 
in fumigating) by subliming. A yellow powder, tasteless, 
and odorless until heated, and insoluble in water. It al- 
ways contains a little sulphuric acid and is only used in 
making other preparations. 

Sulphur Lotum. 
Washed Sulphur. 

Sublimed sulphur washed with aqua ammonias and freed 
from acid. The action is laxative. It is given in pow- 
der mixed with simple syrup or molasses. Dose, 3 i.-iii., 
given at night. 

Sulphur Precipitatum. 
Precipitated Sulphur. 

Dose, 3 i.-iii. 

Potassa Sulphurata. 
Liver of Sulphur. 

Made by fusing sublimed sulphur with carbonate of 
potash. Solid greenish pieces, alkaline, and of very acrid 



60 MATERIA MEDICA FOR NURSES, 

taste ; soluble in water, making an orange-colored sta- 
tion. Locally applied, the sulphuret of potash is an irri- 
tant, and taken internally is a violent corrosive poison. 
It is used in ointments and in giving sulphur baths ; in the 
latter case in a strength of from § i.-vi,, to 30 gallons of 
water. The bath may last from twenty minutes to two 
hours, and has a generally stimulating effect. 

A papular eruption and eczema sometimes follow the 
use of sulphur. 

Calx Sulphurata. 
Sulphurated Lime. 

Contains 36 per cent, of sulphate of calcium. Dose, 
gr. tV-It- 

Unguentum Sulphuris. 

Sulphur in strength of 3 parts in 10, with benzoinated 
lard. 

Ichthyol. 

A preparation obtained from a bitumen 1 found in the 
Tyrol, and supposed to be the residue of extinct fishes. 
It contains 10 per cent of sulphur and is not irritating to 
the skin. It is used externally in an ointment of 10-20 
per cent, strength. 

Carbo (Carbon). 

Charcoal. 

Charcoal is obtained from the combustion of bones, — 
carbo animalis, animal charcoal, or bone black — and of 
wood — carbo ligni, wood charcoal. 

Charcoal absorbs and condenses many gases and vapors, 
coloring matters, alkaloids, and other substances in quan- 
tities many times greater than its own bulk ; and when 
exposed to the air it thus increases rapidly in weight. 

1 An inflammable mineral substance. 



INORGANIC ACIDS. 6 1 

For this reason, when intended for medicinal purposes 
it must be kept carefully covered in well stopped bottles. 

Externally it is used as an absorbent and deodorant 
and internally as a carminative. It may be given be- 
tween two slices of bread and butter or mixed with wine. 
Charcoal does not enter the system but is entirely expelled 
by the bowels. Dose, 3 i.- § i. 

Peroxide of Hydrogen. 

A combination of water and oxygen, used as an anti- 
septic and disinfectant, as it has strong oxydizing 
powers. It is, however, readily decomposed, losing its 
strength and antiseptic power. 

INORGANIC ACIDS. 

Acidum Sulphuricum (Sulphuric Acid). 

Oil of Vitriol. 

Sulphuric acid is made from the gas which is produced 
by the combustion of sulphur, by hydration on the action 
of steam. It is a colorless, oily-looking, intensely acid 
liquid, containing 2 per cent, water. On exposure to the 
air it absorbs moisture and becomes less dense. 

Physiological Actions. 

Sulphuric acid is a powerful corrosive, and abstracts 
water from animal and vegetable tissue, leaving carbon. 
It thus blackens organic matter while destroying its 
texture. 

Concentrated and mixed in a paste with charcoal, sul- 
phuric acid has been used as an escharotic. Diluted, 
its special action both externally and internally is that of 
an astringent. 

Symptoms of Poisoning. 

When swallowed in concentrated form it corrodes the 
alimentary canal, causing acute pain of the mouth, throat, 
and epigastrium. The tongue and lining of the mouth 
are whitened, like parchment, afterwards turning brown, 
while brown or blackened spots appear on the lips. 



62 MATERIA MEDICA FOR NURSES. 

There are : violent vomiting, of tarry matters often, 
cold extremities, and clammy skin ; profuse and bloody 
salivation, suppressed voice, and feeble pulse. The 
face expresses great suffering and anxiety. The mind is 
clear. The matters at first vomited are acid, and, if 
they fall on colored articles of dress the color is taken 
out, and the texture destroyed ; while on black material 
brown spots are produced, with an edge of red. 

There is sometimes perforation of the stomach or 
intestines. The symptoms come on immediately after 
the act of swallowing, and death may result in a few 
hours, but usually delays for from 18 to 24 hours ; oc- 
curring, finally, very suddenly. The smallest fatal dose 
recorded is 3 i. Usually § i. or more has been taken. 

Antidotes. 

The antidotes are chalk, magnesia, whitewash, or soap. 
They should be mixed in milk or water and given freely. 

Preparations. 

Acidum Sulphuricum Dilutum. 
Dilute Sulphuric Acid. 

Has a strength of to per cent, of the acid. 

Dose, TU x.-xxx. (TT[ x. = gtt. x.) 

Acidum Sulphuricum Aromaticum. 
Aromatic Sulphuric Acid. 

Contains alcohol and aromatics, and acid in a strength 
of 20 per cent. Both these preparations should be given 
well diluted, and through a glass tube, to save the teeth 
from injury. 

Dose, TT|, x.-xx. (TT[ x. gtt. xxiv.). 

Acidum Nitricum (Nitric Acid). 
Aqua Fortis. 

Nitric acid is prepared from nitre by distillation with 
water and sulphuric acid. A colorless, intensely acid, 
fuming liquid, containing 70 per cent, acid, the rest 
water. 



INORGANIC ACIDS. 63 

Physiological Actions. 

It is a very powerful caustic, and if used in this way 
the sound tissues should be protected by a coating of oil 
or soap, or sheet-lint wet in a solution of bicarbonate of 
soda, and the spot cauterized be washed with warm soap- 
suds after sufficient effect has been obtained. 

Taken internally in medicinal doses it has stimulant 
and astringent properties. 

Poisoning and Antidotes. 

In concentrated form nitric acid is an exceedingly 
corrosive poison, even more violent than sulphuric 
acid. Like the latter, it destroys the membrane lining 
the mouth, oesophagus, and stomach. The symptoms 
are the same, except that nitric acid stains the tissues 
yellow instead of black. They come on with the same 
severity, and immediately. The antidotes are the same, 
and death occurs on an average in half a day, or a day. 

Preparations. 

Acidum Nitricum Dilutum. 
Dilute Nitric Acid. 

Has a strength of 1 part to 6. It must be well 
diluted and given through a glass tube. 

Dose, Til x. (TT[ x . = gtt. x.). 

Acidum Hydrochloricum. 

Hydrochloric or Muriatic Acid. 

Hydrochloric acid is obtained by the action of sul- 
phuric acid on chloride of sodium, and solution of the 
fumes in water until it has a strength of about 30 per 
cent. An almost colorless, very acid liquid, with pun- 
gent odor. It is one of the natural acids of the stomach, 
and acts as a tonic on the glands of the alimentary 
canal, increasing the normal secretions. Its astringent 
properties are not marked. In concentrated form it is a 
corrosive poison, not as powerful as nitric or sulphuric 
acids. The symptoms and treatment are like the two 
others. 



64 MATERIA MEDICA FOR NURSES. 

Acidum Hydrochloricum Dilutum. 

Dilute Hydrochloric Acid. 

Has a strength of § iv. of the acid to one pint. 
Dose, Til x.-xxx. (TT[ x. = gtt. x.), well diluted and given 
after meals. 

Acidum Nitro-Hydrochloricum. 
Nitro-Hydrochloric Acid. 

Made by mixing three parts of nitric with five parts of 
hydrochloric acid. An orange-colored liquid, changing 
color in time, and more rapidly on exposure to light, to 
a light yellow. In medicinal doses the physiological 
effects are : stimulation of the liver specially, and also 
of the other glands of the alimentary canal. Besides 
being given internally, it is used in local applications to 
the liver, and in baths. In the former case, for stupes, 
the strength is 3 i.-iii. to O. i. of water ; and in the 
latter, § i. to C. i. In poisonous doses the effects are 
the same as the other mineral acids. The stains it 
produces are yellow. The same antidotes are used as 
given before. 

In giving any of the mineral acids, the first symptoms 
of intolerance are : griping pains and diarrhoea, with 
strongly acid urine. These points are to be remembered, 
as well as the necessity for protecting the teeth. 
Acidum Nitro-Hydrochloricum Dilutum. 

Dose, TTj, v.-xx. (ttl x. — gtt. x.), well diluted and 
given through a glass tube. 

Acidum Phosphoricum. 
Phosphoric Acid. 

A colorless, odorless liquid, made by boiling phos- 
phorus with nitric acid and water, and having a strength 
of 66 per cent. It is very acid, but does not corrode the 
tissues. Its physiological effects are unimportant — 
mildly tonic and astringent. 



INORGANIC ACIDS, 6$ 

Acidum Phosphoricum Dilutum. 

Dose, 1U xv.- 3 ss. (TT[ x. = gtt. x.), well diluted. 

Acidum Sulphurosum. 
Sulphurous Acid. 

Made by heating sulphuric acid with charcoal. Sul- 
phurous-acid gas results, and is dissolved in water, 
constituting 5 per cent, of the solution. A colorless 
liquid with pungent sulphurous odor. Sulphurous acid 
is a disinfectant, being very efficient in destroying low 
forms of life. There are several preparations combining 
the alkalies with sulphurous acid, which, however, are 
seldom used. 

Sulphurous-acid gas is used in disinfecting rooms, by 
the combustion of roll sulphur. It should not be relied 
on to the exclusion of thorough cleansing, which is all- 
important. The fumes will tarnish metals, and turn 
black clothes a rusty green. 

Acidum Boricum. 

Boric or Boracic Acid. 

Made by the action of sulphuric acid on borax, or by 
purification of native boric acid, which is a compound of 
the element boron with oxygen, and is obtained from 
certain mineral springs in Italy. White, pearly, glisten- 
ing crystals, soluble in .25 parts of cold and 3 parts 
of hot water. The saturated solution has a strength of 4 
per cent. 

Physiological Actions. 

Boric acid is antiseptic, disinfectant, and deo- 
dorant, destroying low organisms, and stopping fer- 
mentation and putrefactive changes. 

It is not irritating externally, but rather the reverse, 

and when applied to wounds prevents suppuration. 

Internally, in large doses, it is a gastro-intestinal 

irritant, and poisoning has been caused by washing out 

6 



66 MATERIA MEDICA FOR NURSES. 

internal cavities with a 5 per cent, solution. The symp- 
toms were : nausea, vomiting, hiccough, disturbed 
respirations, rapid, feeble pulse, erythema and ecchy- 
mosis, subnormal temperature, and collapse. 

As a wash for babies' eyes and mouths, the saturated 
solution is diluted one half with water. 

It is used as the basis of a variety of mouth washes for 
the sick. It constitutes the largest part of Thiersch 
powder, used in making an antiseptic solution. (See 
salicylic acid.) 

Unguentum Acidi Borici. 

Contains white wax, paraffin, almond oil, and boric 
acid. 

THE ORGANIC ACIDS. 

Acidum Aceticum (Acetic Acid). 

Prepared from wood by destructive distillation and 
purification. A colorless liquid, with pungent odor and 
strong acid taste ; strength $$ per cent. ; the rest water. 

Glacial acetic acid has 99 parts acetic acid to 1 of 
water, and crystallizes at a temperature below 6o°. It 
is not officinal. 

Acidum Aceticum Dilutum. 

Has a strength of 1 part acid to 7 parts water. 

Acetum. 
Vinegar. 

An organic liquid containing acetic acid. It corre- 
sponds nearly in strength with the dilute acid. Vinegar is 
obtained from various vegetables and fruits by a process 
of fermentation known as the acetous or sour, as dis- 
tinguished from the vinous fermentation and others. 

Acetous fermentation may be induced in all liquids 
capable of undergoing vinous fermentation. 

The best vinegar is made from cider. It is often 
adulterated with sulphuric acid. 



THE ORGANIC ACIDS. 6j 

Locally used acetic acid is a caustic. It is best 
applied with a glass rod, or a splinter of wood and needs 
to be applied with care to avoid injuring the surrounding 
parts. 

Diluted and applied to the skin, it is stimulant, as- 
tringent, and refrigerant, and in the form of vinegar 
is sometimes added to baths for the reduction of tem- 
perature. 

Internally it has a stimulating effect on the appetite 
and digestion ; increases the secretion from the intestines, 
and the flow of urine. It does not neutralize the alka- 
linity of the blood, but decomposes there, and combines 
with part of the alkali of the plasma, forming a car- 
bonate, and in this form passes out of the body, unless 
given in excess, when the excess escapes unchanged 
from the kidneys. In the alimentary canal the acid acts 
directly on its contents, and is given in the form of 
vinegar as an antidote for poisoning by alkalies. 

In concentrated doses acetic acid is a corrosive 
poison, and has caused death in one case known. 

The symptoms are like those of the mineral acids, and 
the treatment is the same, consisting in giving alkalies 
and their carbonates ; warm soapsuds, and milk. 

Acidum Citricum (Citric Acid). 

Citric acid is obtained from the juice of the lemon, 
citrus limonum, or of the lime, citrus bergamia, by 
neutralizing the boiling juice with chalk, and putting it 
through various processes. It is very soluble in water, 
and gr. xx. in 3 ss. of water makes a solution resembling 
lemon juice in strength and acidity. 

Citric acid, like the other free acids, acts directly on 
the contents of the alimentary canal, neutralizing alkalies. 

It is stimulant ; relieves thirst and promotes ap- 
petite ; increases the flow of the saliva and of the gastric 
juice ; and, indirectly, the action of the kidneys and 
skin ; hot lemonade especially being a diaphoretic. 

It is slightly laxative, and counteracts a tendency to 
torpidity of the liver. The juice of half a lemon, mixed 



68 MATERIA MEDIC A FOR NURSES. 

with that of an orange, is a satisfactory laxative drink in 
many cases. It is best taken before breakfast. 

In malarial countries lemon-juice is freely used as an 
article of food, and among sailors and soldiers it is used 
as a prophylactic l against scurvy. 

Citric acid has no action on the sound skin ; it is but 
slightly irritating in large quantities internally, and is 
not poisonous. 

It may not be out of place here to refer to a popular 
error regarding a point of diet : that is, that a nursing 
woman may not drink lemonade because it will " sour 
the milk," and " give the baby colic." A nurse will 
probably often be appealed to on this subject. Her 
knowledge of the chemical facts : that citric acid is de- 
composed in the blood, forming a neutral salt ; that it 
does not reach the tissues as an acid, but passes out of 
the body as a carbonate, will at once decide the question. 

Acidum Tartaricum (Tartaric Acid). 

Tartaric acid is the acid of the grape, and js made from 
acid tartrate of potassium by a process similar to that 
used with citric acid. 

Its local action upon abraded surfaces, mucous mem- 
branes, or even the unbroken skin, is that of a decided 
irritant. Taken internally it is diuretic and slightly 
laxative, and somewhat depressing to the heart. 

Tartaric acid does not enter the tissues as an acid, 
but is decomposed in the blood, and passes out of the 
body as a carbonate. 

Poisoning and Antidotes. 

In large doses it is an irritant poison, causing burning 
pain of the oesophagus and stomach, vomiting, and 
gastro-intestinal inflammation, which may prove fatal. A 
dose of § i. has caused death in nine days. The alka- 
lies, magnesia, lime, soapsuds, or the alkaline carbonates 
are antidotes. 

Dose, gr. x.-xx., freely diluted. 

1 A preventive. 



THE ORGANIC ACIDS. 69 

Acidum Lacticum (Lactic Acid). 

Lactic acid is found in sour milk. It is also produced 
by the action of a special ferment on sugar, and is one 
of the normal constituents of the gastric juice. It is a 
pale-yellow, syrupy, inodorous liquid, with acid taste. 

Lactic acid aids digestion and promotes appetite. 
It is credited with the power of dissolving fibrinous exu- 
dations, but its use as an application is very painful. 
Flatulence and epigastric pain result from its too free 
administration. 

It enters the blood as alkaline lactates, is decomposed, 
and excreted by the urine as carbonic acid. 

Acidum Lacticum Dilutum. 
Dilute Lactic Acid. 

Consists of 15 parts acid to 85 parts water. Dose, 
§ ss.-ii., well diluted. 

Acidum Hydrocyanicum. 
Hydrocyanic or Prussic Acid. 

The pure anhydrous ' acid is a colorless, transparent, 
volatile, and inflammable liquid, so poisonous that its 
fumes alone will cause death. 

Its discoverer, Scheele, is supposed to have died 
from inhaling it. It is not officinal, and is only kept in 
laboratories. It is found in nature in a number of vege- 
table substances, viz., peach kernels, bitter almonds, 
wild cherry, cherry laurel, etc. 

Acidum Hydrocyanicum. 
Dilute Hydrocyanic Acid. 

Made by distilling aqueous solutions of ferro-cyanide 
of potassium and sulphuric acid, and diluting the 
product with the water to the required strength. A 

1 Without water. 



70 MATERIA MEDIC A FOR NURSES. 

colorless, watery liquid, containing 2 parts of the pure 
acid to 98 parts of alcohol and water. Its reaction is 
faintly acid ; the taste and odor, like those of peach 
kernels and bitter almonds. Under the influence of 
light it has a tendency to decompose, and should be 
kept in dark-colored, well-stopped bottles. 

Physiological Actions. 

Applied to the skin the acid depresses the sensory 
nerves and causes numbness. It is therefore used for 
various local purposes, largely diluted, but should never 
be applied to an abraded surface, as, being readily 
absorbed, poisoning might result. 

It enters the blood very rapidly, especially through 
the lungs, enters the tissues promptly, and acts chiefly 
on the nervous structures as a sedative and depres- 
sant. The respiratory centre is especially affected, the 
respirations weakened and slowed. The vaso-motor 
centre is stimulated temporarily, and then quickly de- 
pressed. The cardiac centre is also depressed, though 
it is the last to be affected. The sedative action of the 
drug is not confined altogether to the nerve-centres, but 
is shown also on the muscular structure of the heart. 
The motor nerves and muscles are weakened by hydro- 
cyanic acid, the enfeebling action extending downward. 

It is very rapidly eliminated from the system, prob- 
ably by the lungs. This is not, however, a settled point. 
When taken in medicinal doses hydrocyanic acid causes 
a feeling of sleepiness. The first peculiar effects are : 
a bitter taste, an increased flow of saliva, and a feeling 
of irritation and constriction of the throat. These effects 
pass off in half an hour or, at most, an hour. 

When the dose is rather larger than medicinal, viz., 
about TT[ xxx. of the weak acid, there may be noticed : 
nausea, transient giddiness, faintness, a feeble pulse, and 
general muscular weakness. Sometimes there is vomit- 
ing, or foaming and frothing at the mouth, with a suf- 
fused or bloated appearance of the face and prominent 
eyes. 



THE ORGANIC ACIDS. 7 1 

Symptoms of Poisoning. 

The inhalation of the vapor, short of a fatal quantity, 
causes giddiness, faintness, embarrassed breathing, a 
weak, small pulse, and even coma and insensibility, 
followed by recovery. 

If death results from small doses, there are commonly 
present tetanic spasms, lockjaw, and involuntary evacua- 
tions. 

Prussic acid is one of the most powerful poisons 
known, and after a toxic dose the symptoms come on 
instantly, and death may result in a few moments. 
Among its most marked effects are the insensibility and 
loss of muscular power, which are produced much more 
rapidly than by any other poison. 

There is usually loss of consciousness in a few sec- 
onds ; the eyes are protruding and shining, the pupils 
dilated and irresponsive to light ; the limbs relaxed and 
covered with clammy sweat ; the pulse imperceptible ; 
respiration very slow and convulsive, sometimes ster- 
torous, sometimes gasping, or sobbing, the act of expira- 
tion being long and forced, with a pause afterwards 
during which the patient seems dead. 

There is usually an odor of the acid on the breath. 
When the poisonous dose is small, yet still fatal, there 
are often convulsions, spasmodic clinching of the fingers, 
and contraction of the toes. 

The smallest fatal dose recorded was an amount 
equivalent to gr. t 9 q- of pure acid. This caused death in 
twenty minutes. Probably the average fatal dose is 
about gr. i. of pure acid, and the average time of death 
from two to ten minutes. It is not an accumulative 
poison. 

Treatment of Poisoning. 

There is no chemical antidote which acts quickly 
enough to be of any service. Cold-water affusions to 
the head and spine, and artificial respirations, are of 
more service than any thing else, and should be perse- 
vered in, especially the latter, as long as there is any 



72 MATERIA MEDICA FOR NURSES. 

sign of breathing ; as, if the tendency to death from 
apnoea be combated until the influence of the poison 
begins to pass off, life may be saved. The stomach may 
be emptied by emetics or the stomach-pump ; inhalations 
of ammonia and chlorine water given ; and injections 
hypodermically of ammonia, ether, and alcoholic stimu- 
lants. 

Dose of dilute acid, TH, i.-iii. (TTj, i. = gtt. i.). 

Acidum Oxalicum (Oxalic Acid). 

Oxalic acid is never used in medicine, but, as a 
poison, it has caused accidental death so often that 
it will be included here. There are two forms of oxalic 
acid : one, the simple acid, which is found in sorrel and 
several other vegetable substances ; the other, the article 
known as essential salt of lemon, one of the most violent 
of the corrosive poisons, and often mistaken for Epsom 
salt. 

Symptoms of Poisoning. 

A hot acrid taste, and burning in the throat and 
stomach ; intense abdominal pain, and vomiting of 
greenish, brown, or bloody mucus of very acid reaction ; 
livid, cold skin ; small, irregular pulse ; unconscious- 
ness, stupor, and collapse. In some cases the gastric 
symptoms predominate, in others the nervous symptoms, 
as convulsions, numbness, paralysis, and stupor. 

The smallest fatal dose known is 3 i. An ounce 
usually proves fatal, and the symptoms appear imme- 
diately. Death may occur within a few minutes, or may 
b>e delayed more than a week, and then take place from 
starvation resulting from the injuries to the intestinal 
canal. 

Treatment of Poisoning. 

The immediate administration of an antidote is of the 
greatest importance. Neither potash nor soda can be 
used, as their oxalates are poisonous ; but lime or chalk 
are perfect antidotes, and can be given as precipitated 
chalk or saccharated solution of lime, or they may 



THE CARBON COMPOUNDS. 73 

be scraped off the wall, whitewashed fences, or ceilings, 
stirred up in milk, and freely administered. Emetics, 
followed by the soothing and demulcent drinks usual in 
the after-treatment of irritant poisons, are employed, and 
stimulants, with external warmth. 

THE CARBON COMPOUNDS. 
Alcohol. 

Alcohol is a product which results from a process 
of fermentation in substances containing grape-sugar — 
called the vinous fermentation in distinction from the 
acetous or vinegar-forming process. 

At a temperature of 8o° F., the presence and growth 
of the fermenting body (a low vegetable organism called 
the yeast-plant) converts a solution of grape-sugar into 
alcohol and carbonic acid. Starchy substances yield 
alcohol, starch being convertible into grape-sugar. 
From these vinous or fermented liquors alcohol is 
obtained by repeated distillation. It is also made syn- 
thetically, 1 by shaking defiant gas (a gas composed of 
carbon and hydrogen, which is generally present in coal 
gas, oil gas, and other gaseous mixtures produced by 
the action of heat on organic substances) with strong 
sulphuric acid, diluting and distilling. Alcohol is a 
colorless, volatile liquid, of strong pungent odor and 
burning taste ; it is inflammable, burning without smoke 
and with a blue flame, evaporates on exposure to the air, 
is vaporized by heat, and unites readily with water in all 
proportions. 

There are three important alcohols or varieties of 
alcohol, viz. : 

i. Alcohol Ethylicum, Ethyl Hydrate, Grain 
Spirit. This is the alcohol of common language. 

2. Alcohol Amylicum, Amyl Hydrate, Potato 
Spirit, called fusel oil, and obtained also as an impurity 
in the production of ethylic alcohol by continuing the 
distillation after the pure spirit has ceased to come 
away. Amylic alcohol is not inflammable. 

1 By uniting elements into a compound. 



74 MATERIA MEDICA FOR NURSES. 

3. Alcohol Methylicum, Methyl Hydrate, 
Wood Spirit. Wood spirit is inflammable, and is 
cheaper than alcohol. 

Physiological Actions. 

Alcohol is locally antiseptic and disinfectant, 
cooling, and astringent. Internally, in medicinal 
doses it is pre-eminently a heart stimulant, and, in 
a lesser degree, a diuretic, diaphoretic, and anti- 
pyretic. 

Under certain conditions, it is a food ; under still 
others, a poison. 

When rubbed into the skin, as for the prevention of 
bed-sores, it disinfects and hardens it, checks the activity 
of the sweat glands, and irritates the cutaneous nerves, 
causing redness, heat, and local anaesthesia. Applied 
and allowed to evaporate, as in sponge baths, it has a 
cooling action. Coming in contact with an abraded 
surface it is very painful. It is absorbed by the un- 
broken skin. In the stomach it produces a sense of 
warmth, and, in moderate amount, stimulates the mucous 
membrane and dilates the small vessels, with the result 
that the blood supply is increased and the gastric secre- 
tions correspondingly abundant. 

When used in doses sufficient to give this result 
simply, alcohol is evidently favorable to digestion, but in 
larger quantities it has another and unfavorable action, 
namely, that of precipitating the pepsin of the stomach. 

Overdoses produce this result ; a small quantity, di- 
luted as it is by the gastric fluids, has not sufficient 
power to act on the pepsin to any marked degree. If 
alcohol is constantly used to excess, an abnormal secre- 
tion of mucus — gastric catarrh — results, with various 
evidences of dyspepsia, viz. : loss of appetite, acidity of 
stomach, heartburn and pyrosis, nausea, and morning 
vomiting. 

Other evidences of the alcohol habit are : constipa- 
tion ; pain on pressure over the stomach ; brown, dry 
tongue with red tip ; chronic pharyngitis ; fat, flabby, 
soft hands. 



THE CARBON COMPOUNDS. 75 

Sleep, for the first part of the night, is sound, but is 
disturbed in the early morning, after which wakefulness 
remains, or broken sleep with bad dreams. 

Confirmed drinkers age fast. The skin becomes dry, 
and feels waxy, soft, and unhealthy. The mind becomes 
sluggish and weak, and cirrhosis of the liver and kid- 
neys, phthisis, epilepsy, paraplegia, insanity, and other 
disorders are among the sequels of alcoholism. 

Symptoms of Poisoning. 

A steady course of alcohol in excess, without taking 
food, will result in delirium tremens. Acute alcoholic 
poisoning presents the following symptoms : a short 
period of excitement, followed by coma ; respirations 
irregular, sometimes sighing but usually stertorous ; 
pupils either dilated or contracted, usually the former ; 
face flushed ; pulse hard, rapid, and strong. 

Acute alcoholic poisoning may be mistaken for opium 
poisoning, apoplexy, and compression of the brain. 

Death results from paralysis of the heart and respira- 
tions. The time at which death may occur varies from 
a few minutes to several days. 

The smallest known fatal dose was between § iii.-iv. of 
brandy swallowed by a child of seven years. 

Treatment of Poisoning. 

The treatment consists in emptying the stomach ; the 
application of heat to the extremities and cold affusions 
to the head ; the inhalation of ammonia, and the use of 
electricity applied to the respiratory muscles. 

Physiological Actions (Continued). 

Alcohol enters the blood unchanged or as aldehyde, 1 
and reaches the tissues and organs, a small portion being 
changed into acetic and carbonic acids. In its passage 
through the tissues it is oxydized, if given in moderate 
amount, and changed into carbonic acid and water, like 
other carbo-hydrates, — thus becoming a food or source 
of heat and force. 

1 Alcohol deprived of a certain proportion of its hydrogen. 



76 MATERIA MEDIC A FOR NURSES. 

In a healthy adult, § iss. of absolute alcohol can be 
thus oxydized in twenty-four hours, and supplies to the 
organism as much heat and energy as is contained in the 
same amount of cod-liver oil or in about § ix. of beef. 

Beyond this, in health, it becomes injurious, and is 
eliminated by the kidneys, skin, and lungs ; though in 
different morbid states large — even excessive— quanti- 
ties can be safely taken. 

Children and old people bear alcohol well. 

Although alcohol is itself oxydized, it interferes with 
the oxidation of other substances, thus saving the tissues 
from wear and retarding the process of waste. 

This, joined to its stimulating action on the circulation 
and on the nervous system, gives it the power of sustain- 
ing life for a time, under the strain of acute exhausting 
disease, or during a period of temporary inability to take 
sufficient food. 

Its stimulant effect is shown on the heart by an in- 
crease in the strength of the contraction or systole. The 
pulse becomes strong and regular, full, and compressible. 
If it had, before, been rapid and weak, it will, under the 
favorable influence of alcohol, become reduced in fre- 
quency to near the normal ; but, if over-stimulated, this 
shortening of the period of rest will in time exhaust the 
heart. 

In giving alcohol as a medicine, it is important to be 
able to recognize the first evidences of over-stimulation 
as given by the pulse. 

The " whiskey pulse " as it is called, is unnaturally 
strong, full, frequent, and bounding. 

On the brain and nervous system alcohol acts as a 
stimulant, up to a certain point ; beyond that, as a de- 
pressant and narcotic. 

On the circulation and bodily heat its action would, at 
first sight, seem to be contradictory. The sense of 
warmth given by a dose of alcohol seems incompatible 
with the well proved facts that the bodily heat is, on the 
whole, lowered by alcohol, and that the nower of ^i? + 
tance to cold is weakened by it? ™~? 

The physiological explanation is, thau the blood-vessels 



THE CARBON COMPOUNDS. 77 

are dilated by the stimulus of alcohol, — the blood rushes 
to the surface to fill the superficial vessels, and a feeling 
of warmth results, which, in a warm or moderately cool 
atmosphere, remains, and promotes the general comfort ; 
but, in a cold atmosphere, the supply of blood to the sur- 
face being so much larger than ordinary, and perspira- 
tion being also increased, while active tissue-changes are 
checked, heat is abstracted from the body by evaporation 
at a rate which soon affects the vital powers seriously. 

In giving stimulants there are various points to notice 
by which to judge whether it is doing good or not. 

The pulse has been mentioned ; the tongue gives 
another indication. If a dry tongue becomes moist un- 
der the influence of alcohol, it is acting well ; if the dry- 
ness of the tongue be increased, it is not, and the same 
rule applies to the skin. If nervousness is quieted, sleep 
induced, delirium and subsultus lessened by alcohol, it is 
acting favorably ; if restlessness and uneasiness follow, or 
increased delirium, or sleeplessness, — unfavorably. 

In cases of sudden heart failure alcoholic stimulants are 
given hot and concentrated. 

Preparations of Alcohol. 

Spiritus Rectificatus. 
Rectified Spirit. 

Contains 85 per cent, of pure ethylic alcohol with 15 of 
water. 

Absolute Alcohol. 

Made from the rectified spirit by a lengthy chemical 
process, in which carbonate of potash and chloride of 
calcium are used. It consists of 99 parts pure alcohol 
with 1 of water, and is not kept for sale but used only for 
pharmaceutical purposes. 

Spiritus Tenuior. 

Proof Spirit. — Equal parts of alcohol and water, or, 
strictly speaking, 49 per cent, alcohol. 



7§ MATERIA MEDICA EOR NURSES. 

Alcohol Dilutum. 
Dilute Alcohol. 

Equal parts of alcohol and water. 

Alcohol. 

Contains of absolute alcohol 94 parts by volume (91 
parts by weight). 

Alcoholic Beverages. 

Spiritus Frumenti. 

Whiskey. — Made in the United States from rye and 
corn, in Scotland from barley, and in Ireland from 
potatoes. 

It has from 44 to 50 per cent, by weight of ethylic alco- 
hol (by volume 50 to 56 per cent.), and contains ethers 
which are developed in the course of its fermentation ; 
and, even in the best varieties, some traces of fusel oil. 
Whiskey should be at least two years old before it is used. 

It is sometimes necessary or convenient to use alcohol 
instead of whiskey. The ordinary dose of § ss. whiskey 
is represented by a little over 3 ii. of alcohol, or by § ss. 
of dilute alcohol. 

Spiritus Vini Gallici. 
Brandy. 

Brandy should be distilled from grapes, but it is also 
made artificially. It has about the same percentage of 
alcohol as whiskey. It may be either pale or dark ; in 
the former case it is colored by the cask, in the latter it 
contains caramel. It should be at least four years old. 
Brandy has a more sedative action on the stomach than 
whiskey, and is preferable where there is any tendency to 
diarrhoea, as it is slightly constipating, containing a little 
tannin. Both brandy and whiskey are more easily taken, 
as medicines, if poured over a small glassful of cracked 
ice ; or they may be diluted with carbonated or seltzer 
water more acceptably than with plain water. Giving 
them in milk very often causes patients to take a dislike 
to the milk. They are both used hypodermically, and for 
this purpose should always be filtered. 






THE CARBON COMPOUNDS. ?9 

Rum. 

Made by the distillation of fermented molasses. 

Gin. 

Distilled from rye or barley, and flavored with juniper 
berries. If it is pure, it is an efficient diuretic, owing to 
the oil of juniper, but it is rarely pure. 

/ Wines. 

Officinal wines are white wine, vinum album, and 
stronger white wine, vinum album fortius. They are 
used in medicinal preparations. White wine contains 
about 10 per cent, of alcohol, and is made from grape 
juice without skins, stems, or seeds. 

All wines contain various acids and traces of mineral 
substances. Those which are free from sugar are called 
" dry " wines. 

The red wines — claret, port, etc., are made from col- 
ored grapes with the skins, and have considerable alco- 
holic strength. Port wine, vinum portense, contains from 
30 to 40 per cent, of alcohol, but is rarely pure. 

As stimulants and in narcotic power these wines 
stand next to brandy and whiskey. They contain some 
tannic acid and are astringent, causing constipation 
and disordering the stomach. They also tend to raise 
the temperature. 

Vinum xericum, or sherry, belongs to the dry spiritu- 
ous wines. It contains 17 per cent, of alcohol, and is 
usually made artificially. It assists digestion if taken 
during meals. 

Sparkling wines, of which champagne is the most im- 
portant, are bottled before fermentation is complete, and 
are effervescent, being charged with carbonic acid. They 
are more intoxicating than others in proportion to their 
strength, are less stimulating to the heart, and liable 
to leave headache and sour stomach as after-effects when 
freely taken. In small doses they are gastric seda- 
tives, champagne especially being so. Given ice-cold 
and in teaspoonful doses, at short intervals, it may be 



80 MATERIA MEDICA FOR NURSES. 

retained by an irritable stomach which rejects every 
thing else. In giving champagne in this way care is 
necessary to prevent escape of the gas and flattening of 
the wine. A champagne tap is used, and the bottle held 
head downward. In the intervals it is kept on ice in the 
same position. 

Sweet wines, including Burgundy and Madeira, ^are 
rather trying to the digestion. They disorder the stom- 
ach and cause headache. They contain 6 or 7 per cent, 
of alcohol. 

Dry acid wines, — the German and some of the French 
wines, are stimulant, and do not cause acid fermentation. 
They contain from 5 to 7 per cent, of alcohol. 

Beer, Ale, Porter, Stout, 

Contain from 2 to 6 per cent, of alcohol ; also extract 
of malt, lactic acid, salts of potash and of soda, and 
aromatics. 

Chloroformum (Chloroform). 

Chloroform is made by the action of chlorine on alco- 
hol. The crude or commercial chloroform, called chlo- 
roformum venale, is purified by an intricate chemical 
process and called chloroformum purificatum. 

Physiological Actions. 

Externally applied and allowed to evaporate, chloro- 
form causes a sense of coldness and depresses the termi- 
nations of the sensory nerves, acting as an anodyne and 
producing insensibility to pain. If evaporation is pre- 
vented it irritates, reddens, and blisters the skin. These 
effects are followed by anaesthesia of the part. Given 
by mouth, chloroform has a hot, sweet taste, and in the 
stomach produces a feeling of warmth. In large quanti- 
ties or undiluted it causes violent gastro-enteritis. Me- 
dicinally it is given as an antispasmodic, anodyne, 
and carminative. It enters the circulation through the 
lungs, stomach, and unbroken skin. It reaches the tis- 
sues very rapidly, and exerts its greatest power on the 
central nervous system. It is excreted partly as chloro- 
form by the kidneys, lungs, mammary glands, and skin, 
and part is lost in the system. 



THE CARBON COMPOUNDS. 8 1 

Symptoms of Poisoning. 

In poisoning by chloroform taken internally the symp- 
toms are stupor ; cold skin covered with perspiration ; 
pulse slow, thready, sometimes almost imperceptible ; 
respirations at first stertorous, afterwards becoming shal- 
low, irregular, and infrequent. The symptoms come on 
almost immediately after it has been swallowed, and 
death may result in a few hours, or may result after a 
longer time from gastro-enteritis or from inflammation 
of the trachea. 

Treatment of Poisoning. 

There is no antidote for chloroform, on account of its 
extremely rapid diffusibility through the system. The 
stomach must be emptied ; washed out, if necessary, and 
cold-water affusions applied to the head, and plenty of 
fresh air admitted. Artificial respiration should be prac- 
tised steadily and unremittingly. 

The smallest fatal dose recorded is 3 ii. 

Dose of chloroformum purificatum, TTL xv.-xxx. (TTj, x. 
= gtt. lx.). 

Spiritus Chloroformi. 

Strength of 10 per cent. Dose, 3 ss -i., well diluted. 

Mistura Chloroformi. 

Chloroform, 8 per cent., and a small proportion of 
camphor. Dose, § ss. 

Chlorodyne. 

A proprietary medicine containing chloroform, ether, 
morphia, cannabis indica, and hydrocyanic acid. 

Dose, fTL v.-xxx. (TTl x . = gtt. xx.), well diluted. 

Linimentum Chloroformi. 
Chloroform Liniment. 

Composed of soap liniment, 6o parts, and chloroform 
venale 40 parts. 
6 



82 MA TERIA MEDICA FOR NURSES. 

In the use of the vapor of chloroform as an anaesthetic 
there are three stages of narcosis : the first, a short 
period of excitement during which the sensibilities are 
blunted, though consciousness is not lost ; second, the 
stage of anaesthesia. Consciousness and sensibility are 
abolished ; the pulse is about normal in frequency and 
slightly weaker ; respiration slow, heavy, and stertorous. 
During this period operations are performed. The third 
stage is a dangerous one, with profound narcosis ; entire 
muscular relaxation ; stertorous breathing, gradually be- 
coming sighing and weak ; and complete abolition of 
reflex actions. 

Chloroform is preferred to ether in some cases because 
it is easier and pleasanter to take ; is more prompt in its 
action ; is not so nauseating, and its after-effects pass 
away more quickly. In obstetrical cases it is preferred 
because by its use a state of insensibility to pain can be 
produced without bringing on complete muscular relax- 
ation, which would delay labor. 

No fatal cases are known to have occurred in parturi- 
ent women, although in surgical cases death has occurred 
quite frequently and with great suddenness, from paraly- 
sis of the respirations and heart, and ordinarily chloro- 
form is considered much less safe than ether. In giving 
chloroform to a patient in labor (which a nurse may be 
required to do), the face must first be oiled with vaseline 
to prevent any possibility of blistering. 

About 3 ss. of chloroform is poured at one time on a 
sponge, or piece of lint, and held before the nose in a 
way that will allow plenty of air to mix with it, as the 
chloroform should only be in a strength of 3 per cent, 
with the inspired air when inhaled. 

It is only to be inhaled during the existence of a pain, 
and not in sufficient quantity to lessen uterine contrac- 
tion. If the pulse weakens, the respirations grow shal- 
low, or the pains become insufficient it is stopped. 

It is well to keep the supply safely out of reach in the 
case of excitable and hysterical patients. 

In the treatment of poisoning by inhalation of chloro- 
form vapor, the head is lowered to an angle of about 40 . 



THE CARBON COMPOUNDS. 83 

Plenty of fresh air is needed, and should be warm, about 
8o°-85° F. External heat must be applied, inhalations 
of nitrite of amyl may be used, and artificial respiration 
kept up for several hours. 

iEther (Ether, Ethyl Oxide). 

A colorless, volatile liquid, made by the action of sul- 
phuric acid on alcohol, by a very elaborate process. It 
evaporates rapidly on exposure to the air, and is very 
inflammable, as is also the vapor. The odor is very 
strong, heavy, and peculiar. 

Physiological Actions. 

Applied to the skin and allowed to evaporate, ether is 
a refrigerant and local anaesthetic of such power that 
minor surgical operations are sometimes performed 
under its local influence ; the part to be operated on — 
as, for instance, a finger — being sprayed with ether until 
benumbed, a process which only requires a few moments' 
time. 

Internally it has a strong burning taste, is irritant to 
mucous membrane, and causes salivation through reflex 
action. In the stomach it acts as a local stimulant and 
carminative, and also, by reflex action, as a stimulant 
to the heart, respiratory organs, brain, and intestines. 

It is an antispasmodic, anthelmintic, and dia- 
phoretic. When inhaled it first produces a strong 
irritation of the throat, with a strangled feeling. The 
cerebrum is first affected by the use of ether as an anaes- 
thetic ; the sensory and motor nerves next ; the centres 
of respiration and circulation in the medulla are the last 
to become influenced, and continue to act, unless the 
anaesthetic is pushed too far, when the respirations die 
away, the heart continuing to beat after breathing has 
stopped. 

The state of the bladder must be carefully watched in 
all cases after etherization, as there is often retention of 
urine. External heat must be plentifully supplied, and 



84 MA TERIA ME DIC A FOR NURSES. 

the facility with which an insensible patient may be 
seriously burned by hot-water bottles and bags should be 
constantly kept in mind. The effects of the ether are 
allowed to pass off quietly of themselves, plenty of fresh 
air being secured, any effort at vomiting being best over- 
come by giving a teaspoonful of very hot water at inter- 
vals. If there is no tendency towards collapse, cracked 
ice in small quantities may be used. 

In preparing a patient for etherization, definite orders 
from the surgeon are always received, and it is only 
necessary here to speak of the absolute importance of 
having the stomach, bowels, and bladder entirely empty. 

Death from strangulation may be caused by a fragment 
of vomited food lodging in the windpipe, and the bowels 
and bladder, if not thoroughly attended to, will empty 
themselves spontaneously. 

Ether is excreted like chloroform, and rapidly. 

Preparations of Ether. 

i£ther Fortior. 

Stronger Ether. — Called sulphuric ether. It is the 
preparation used in anaesthetizing, and contains 6 per 
cent, alcohol and a little water. 

Spiritus ^Etheris. 

Has 30 parts of ether and 70 of alcohol. 
Dose, 3 i., well diluted with very cold water. 

Spiritus Athens Compositus. 
Compound Spirit of Ether. 
Hoffman's Anodyne. 

Contains 30 per cent, ether, with alcohol and ethereal 
oil. It is a carminative, antispasmodic, and 
stimulant. 

Dose, 3 i.-ii., diluted with very cold or iced water. 

Spiritus Athens Nitrosi. 
Spirits of Nitrous Ether. 

Sweet Spirit of Nitre. — A solution of nitrous ether 
in alcohol, made by adding sulphuric and nitric acids to 



THE CARBON COMPOUNDS. 85 

stronger alcohol, adding also some copper wire, and dis- 
tilling. Sweet spirit of nitre is volatile and inflammable. 
It should not be kept long, as it becomes acid with age. 
It is a diuretic and diaphoretic, acting by relaxing and 
dilating the renal and cutaneous vessels. It is also a 
nerve sedative and antispasmodic. 

The action on the skin is made more prominent by 
keeping the patient warmly covered in bed, and on the 
kidneys when kept cool, or out of bed. Like all prepara- 
tions of ether it should be largely diluted and given very 
cold, as this lessens the strangling feeling in the throat. 

The inhalation of sweet spirit of nitre has caused 
alarming symptoms — viz. : pallor, weak pulse, muscular 
weakness, pain about the heart, and headache. 

Taken internally, in large quantities, it has in one 
or two instances caused death. 

Dose, 3 i.- i ss. 

Preparations of ether are given hypodermically as heart 
stimulants, and should be injected deeply into the mus- 
cular tissues to avoid irritation and formation of ab- 
scesses. 

Bichloride of Methylene. 

An anaesthetic obtained from chloroform by the action 
of hydrogen, and somewhat similar in its action. It 
is sometimes used in English surgery. 

Chloral. 

Chloral is an oily colorless fluid made by the action of 
chlorine on alcohol. It is not used in medicine. United 
with water it forms a hydrate which is the chloral of the 
U. S. P. 

Chloral Hydras. 
Hydrate of Chloral. 

Colorless volatile crystals of hot burning taste and 
pungent odor ; readily soluble in water, ether, or al- 
cohol. 



86 MA TERIA MEDICA FOR NURSES. 

Physiological Actions. 

Chloral has antiseptic properties and has been so 
used in a strength of gr. v.- 3 i. of water. A concentrated 
solution vesicates and is very painful. 

Given internally it acts on the nerve centres as a 
sedative, its effect on the brain, under suitable con- 
ditions, being that of a pure and perfect hypnotic. The 
sleep it causes resembles natural sleep, coming on quickly 
and lasting for six or seven hours. The patient may be 
aroused from it for medicine or nourishment, and falls 
asleep again, finally awaking refreshed, and without 
headache or the unpleasant after-effects — such as nau- 
sea, giddiness, and constipation — which are commonly 
found after taking opium. Even if given for a long time 
chloral is not apt to cause constipation or disturbance of 
the stomach. 

In the sleep of chloral the pupil is slightly contracted, 
the pulse unaltered or a little slower than normal, the 
respirations regular, full, and quiet. The cases in which 
its beneficial action are best seen are cases of insomnia 
from mental labor, anxiety, or fatigue. It is not an 
anodyne, having no power to overcome pain unless given 
in dangerous doses. If so given the after-effects are bad. 

The action of chloral is not always satisfactory. With 
some persons headache, excitement, and even delirium, 
are caused by medicinal doses. 

Symptoms of Poisoning. 

In larger doses the respiratory centre is depressed and 
the respirations become slow, irregular, and shallow. The 
activity of the vasomotor centre is lessened, so that the 
vessels dilate generally, and the heart is depressed and 
weakened not only through the centre in the medulla 
but also by a direct influence on its own nerve ganglia. 

The pulse becomes weak and slow ; in toxic doses it 
grows rapid and irregular, and in fatal cases feeble and 
thready, while other symptoms are coma, great muscular 
relaxation, pupils at first contracted, afterwards dilated, 
and death results from paralysis of the respirations and 
heart. 



THE CARBON COMPOUNDS. 87 

Treatment of Poisoning. 

The treatment in chloral poisoning consists in the use 
of alcoholic stimulants, strong coffee, galvanism, and 
artificial respiration. The application of external heat 
is of the utmost importance. Mustard pastes and hot 
mustard foot-baths may be used, avoiding, however, all 
measures which might exhaust the patient. 

Incidental Effects. 

There may be noticed after ordinary doses of chloral, 
dyspnoea ; redness and swelling of the conjunctivae ; and 
eruptions of the skin, most frequently a simple erythema 
which seems to follow preferably the course of the large 
nerve trunks. Sometimes the eruption takes the form 
of wheals, and a papular eruption has also been ob- 
served. These disorders are often attended by some 
rise of temperature, and desquamation sometimes results. 
It is supposed that they, as well as the more alarming ill 
effects of chloral, are greatly, if not altogether, due to 
impurities of the drug. 

The great danger of chloral is the sudden paralysis of 
the heart, which may occur even after ordinary medici- 
nal doses, and without warning. This attaches so much 
uncertainty to its action that it is impossible to express 
caution too strongly in regard to using it without orders. 
The patient may be sleeping quietly, but suddenly be- 
comes restless and passes into a state of syncope. The 
danger cannot be considered past until from 60 to 100 
pulse beats can be counted continuously without any 
irregularity in strength. 

The habitual use of chloral may become a disorder 
almost as grave as the opium habit. Those who have 
formed this habit are usually excitable in manner ; hur- 
ried and voluble in speech ; nervous and wakeful at 
night ; melancholy and low-spirited during the day, and 
subject to vertigo and ringing in the ears. 

The eyes are brilliant and restless ; the appetite capri- 
cious or lacking altogether ; digestion disordered ; the 
heart action weak and irregular, and the secretion of bile 
deficient. 



55 MATERIA MEDIC A FOR NURSES. 

Dose, gr. v.-xx., diluted only moderately with water 
or a weak syrup. 

Butyl Chloral Hydrate. 
Croton Chloral. 

A crystalline body formed by the action of chlorine on 
aldehyde ; sparingly soluble in water, readily so in 
glycerine. It is said to resemble chloral in its action, 
but to be more depressing and less efficient. A feebler 
poison, more disagreeable in taste, and having a special 
anaesthetic effect on the fifth nerve. 

Dose, gr. v.-xx., in syrup or glycerine. 

Metachloral. 

A solid substance prepared by acting on chloral 
hydrate with sulphuric acid, and used as a counter- 
irritant and local anaesthetic. 

Chloral Camphor. 

Equal parts of camphor and chloral, used as an ex- 
ternal application for the relief of pain. 

Paraldehyde. 

Made by treating aldehyde with sulphuric or nitric 
acid. Aldehyde in chemical constitution is between an 
alcohol and an acid, and is produced by taking away 
two atoms of hydrogen from, an alcohol. 

Paraldehyde is a colorless liquid solidifying below 50 
F., and soluble in ten parts of water. It has a strong 
ethereal odor and unpleasant taste. It is a pure 
hypnotic, like chloral, having about half its power and 
many of its qualities without the dangers of chloral. 

In its action the cerebrum is first affected, and sleep 
induced with no primary stage of excitement. The 
medulla is next affected, and next the spinal cord. It 
has little or no control over pain. In medicinal doses 
it is not paralyzing to the heart, and does not, as a rule, 
leave headache or unpleasant after-effects. 

It is irritant to mucous membrane, and is likely in 



THE CARBON COMPOUNDS. 89 

time to impair digestion. It gives an unpleasant odor to 
the breath, and if used for a long time it may produce 
nasal ulcers, cerebral congestion, and vasomotor paraly- 
sis. It sometimes causes erythema or reddening of the 
skin. 

Dose, TT(, xxx.- 3i. (ill x. = gtt. xxv.), in water, either 
plain or with simple syrup. It must be well diluted. 

Sulfonal. 

Sulfonal is an alcohol derivative, belonging to what 
are chemically known as the sulphur compounds of 
alcohol. It has hypnotic action. It is a white, odor- 
less, and tasteless powder, almost insoluble in water, 
requiring from 100 to 150 parts of cold, and 18 or 20 of 
boiling, water to dissolve it. 

In favorable instances it produces a physiological 
sleep, which lasts for several hours, with no unpleasant 
after-effects. With susceptible cases sleep has been 
known to come on in an hour or little over, but as a 
usual thing sulfonal is rather slow in action, sometimes 
not taking effect for several hours, sometimes even not 
until the next day ; and in these delayed cases, sleep, 
when it does come, is prolonged and dull. In a certain 
number of cases sulfonal fails to act satisfactorily, and, 
in these, nausea, mental excitement, vomiting, dizziness 
and staggering, headache and depression have been ob- 
served after its use. 

It may be given dry on the tongue, but is best given 
in hot milk, or soup, or beef-tea, with plenty of salt. 
Large amounts of warm fluids favor its absorption, and 
as it is often slow in action it is better given early in the 
evening. Dose, gr. xx.-xxx. 

Hypnone. 

A new hypnotic, produced chemically as a derivative 
of alcohol. A colorless liquid having a strong odor of 
almond or orange. It is not dangerous, and leaves no 
ill after-effects except a disagreeable odor to the breath. 

Dose, fit v.-x., in capsule, being insoluble in water. 



90 MATERIA MEDICA FOR NURSES. 

Urethan. 

A combination of carbonic acid and ethylic ether, 
lately introduced as a hypnotic. Its action is rather 
uncertain, and resembles paraldehyde. It has no power 
over pain, is not depressing or irritating to the stomach, 
and under favorable circumstances has induced sleep 
in 15 or 20 minutes, and prolonged it for 6 or 8 hours. 
It is soluble in water, and may be given hypodermically, 
as it is not irritating. 

Dose, gr. x.-lx., best given in pellet, wafer, or capsule. 

Amylene Hydrate. 

An alcohol derivative, with properties as a hypnotic, 
its power being considered intermediate between chloral 
and paraldehyde. It is a clear liquid, soluble in 8 parts 
of water, and readily so in alcohol. It is agreeable to 
the taste and not dangerous, having, in medicinal doses, 
no depressing effect. Very large doses paralyze the 
respiratory centre, and also the heart 

Dose, 3 i.-iss. 

Amyl Nitris (Nitrite of Amyl). 

Nitrite of amyl is produced by distilling nitric acid 
with amylic alcohol (fusel oil), sulphuric acid, and cop- 
per, and purifying with alkalies by various intricate pro- 
cesses. An ethereal liquid of yellow color and fruity 
odor. 

It is given by inhalation usually. The vapor enters 
the blood through the lungs with extreme rapidity, reach- 
ing the tissues and producing its characteristic effects 
almost instantaneously. 

Nitrite of amyl is a motor depressant. Its leading 
physiological action is upon the spinal cord and the cir- 
culation, other effects being secondary. The motor 
centres in the cord are directly and strongly depressed, 
and a similar but less powerful action is exerted on the 
motor nerves and muscles. The sensory nerves are but 
little affected. 



THE CARBON COMPOUNDS. 9 1 

Two effects are produced on the circulation. First, 
the muscular walls of the arteries are paralyzed ; the 
vessels dilate, and the blood pressure falls. Second, by 
this reduction of the blood pressure the resistance which 
was met by the left ventricle in discharging its contents 
disappears, with consequent relief to the heart, which has 
at once less work to do, with the same, or increased 
strength, to do it. The heart-beats are increased in 
number — not always in force, — and the depression of 
the inhibitory apparatus gives the beats an energetic and 
thumping character. 

In this way nitrite of amyl acts as a heart stimu- 
lant, not by actually strengthening the heart itself, but 
by clearing away obstructions to a free circulation which 
increased the work of the heart and exhausted it by com- 
pelling it to put forth abnormal exertions. 

From 2 to 5 drops, inhaled, will give this result, with 
the attendant symptoms of fulness and throbbing of the 
head, amounting sometimes to severe pain. 

If inhalation is carried beyond this there will be ver- 
tigo ; flushing of the face, with visible pulsation of the 
carotids ; deep, labored respiration ; tingling of the sur- 
face ; dilatation of the pupils ; restlessness and anxiety. 
These symptoms disappear rapidly on the withdrawal of 
the drug, and the heart-beats fall to normal. 

It is stated that all objects look yellow to one fully 
under the influence of nitrite of amyl. 

Larger doses increase all these symptoms in severity, 
to the point of grave depression, with cold extremities ; 
heavy clammy perspiration ; slow, almost imperceptible 
pulse ; irregular respirations ; and severe persistent head- 
ache. There may sometimes be convulsions. Toxic 
doses paralyze the heart and respiratory • centres. In 
cases of poisoning by nitrite of amyl all the blood of the 
body becomes a uniform hue, which is described as being 
nearer a chocolate color than ordinary venous blood. 

The poisonous dose is not certainly known. A dessert- 
spoonful taken internally has been recovered from, by 
the aid of emetics, and hypodermically 3 ii. have been 
given in an hour and a half without unpleasant symptoms. 



92 MATERIA MEDICA FOR NURSES. 

In giving inhalations of nitrite of amyl, from 3 to 5 
drops are placed on a handkerchief, or piece of lint or 
cotton, held near the nose, and withdrawn as soon as 
fulness in the head or flushing of the face is produced. 
The symptoms usually are a little more prominent for a 
moment or two after the drug has been withdrawn. It 
has been given hypodermically and also by mouth. In 
the latter way the dose is TT], ii.-iii. on sugar (TT[ x. = gtt. 
xxx.). 

Nitrite of amyl escapes by the kidneys. The urine is 
increased in amount and in acidity, and may sometimes 
contain sugar. 



Nitro-Glycerinum (Nitro-Glycerine), Trinitrine, 
Glonoin. 

Made by dropping glycerine in a mixture of sulphuric 
and nitric acids kept ice-cold ; separating by pouring 
the product into water, washing, and evaporating to a 
proper density. A colorless, oily liquid, odorless, with 
sweet, pungent taste ; slightly soluble in water and freely 
so in oils, alcohol, and ether. 

If heated in a close vessel, or if subjected to percus- 
sion, it will explode. Mixed with porous silica, nitro- 
glycerine constitutes dynamite. It is never used undiluted 
in medicine. 

Physiological Actions. 

Nitro-glycerine is the most powerful of the nitrites. 
Its physiological actions resemble very strongly those of 
nitrite of amyl but in a greater degree, and the effects, 
while less prompt in appearing, are more lasting, being 
developed in from three to five minutes, and continuing 
for about forty-five minutes. 

Depression of the motor centres, dilatation of the 
blood-vessels and lowering of the blood pressure are the 
chief factors in the action of nitro-glycerine. The first 
signs manifest are perspiration and quickened heart 



THE CARBON COMPOUNDS. 93 

action, with, sometimes, a dicrotic pulse ; disturbed 
respiration, flushed face, vertigo, constriction of the head 
and throat, occasional nausea, throbbing of the carotids, 
and headache, which is of a severe frontal type, and lasts 
sometimes for hours after other effects have worn away. 
In some cases albumin in the urine is diminished by 
nitro-glycerine. 

Symptoms of Poisoning. , 

Poisonous doses cause heart failure, with slow, inter- 
mittent, and very irregular pulse ; dilated pupils ; a 
feeling of weakness in the epigastrium ; and intense 
headache, with a feeling as of a tight band around the 
head. 

Symptoms of poisoning not resulting in death have 
followed doses of from two to ten drops of the alcoholic 
solution. 

Nitro-glycerine is given in tablets, or in the form 
of the alcoholic solution, strength 1 per cent. This 
preparation should be constantly renewed, as it decom- 
poses with age. In the case of an unconscious patient 
it may be dropped on the back of the tongue. 

Dose, TT[ ss.-ii.; iii.; in a little glycerine (lU x. = gtt. 
xxv.). 

Carbolic Acid, Phenol, Phenylic Alcohol. 

Carbolic acid is produced by distilling coal tar at a 
high temperature — between 356 and 374 F. It is not 
a true acid, as it does not turn blue litmus paper red, but 
it is one of the aromatic series of carbon compounds, 
and resembles alcohol in chemical constitution. It is 
neutral in reaction, is soluble in twenty parts of water, 
and freely soluble in glycerine, alcohol, ether, etc. The 
crystals deliquesce on exposure to air, and can be readily 
melted for use in making solutions by standing the bottle 
in a vessel of hot water. A solution for surgical purposes 
must be perfectly clear. If it is cloudy or contains glob- 
ries it is not thoroughly mixed, and will be far more 
irritating than otherwise, 



94 MATERIA MEDIC A FOR NURSES. 

Physiological Effects. 

Carbolic acid applied locally is antiseptic, irritant, 
and anaesthetic. In concentrated form it is a severe 
caustic. The vapor, internally, is stimulant and disin- 
fectant. Taken into the stomach the acid arrests fer- 
mentative changes, and in large doses is a powerful 
irritant and narcotic poison, acting on the respiratory 
and vasomotor centres, which it quickly paralyzes. It 
is rapidly absorbed by the unbroken skin, the subcuta- 
neous tissues, the mucous surfaces, wounds, the respira- 
tory passages, and the stomach, and is excreted by the 
urine, to which it gives a dark, smoky, or greenish color ; 
also by the saliva, which is increased in quantity. 

Carbolic acid is a deodorizer and disinfectant as 
well as an antiseptic. It is very destructive to low forms 
of life if used in sufficient strength, but in solutions of a 
strength which may be safely used externally, as in the 
dressing of wounds, or internally, as for vaginal douches, 
it only prevents the development of germs, and does not 
kill their spores. 



Symptoms of Poisoning. 

The first signs of poisoning from the use, either ex- 
ternal or internal, of carbolic acid, are : giddiness, 
tension of the head, and, usually, the dark color of the 
urine. More serious evidences of danger are : con- 
tracted pupils ; pallor ; embarrassed breathing ; a small, 
slow, feeble pulse ; ringing or singing in the ears ; and 
sudden vertigo. 

When swallowed in poisonous doses there is at once a 
hot burning sensation from mouth to stomach, and the 
symptoms come on immediately. The lips and lining of 
the mouth are white and hardened ; there is nausea, with 
violent pain and vomiting of frothy mucus ; the lips, ears, 
and eyelids are livid ; the pupils contracted and insensible 
to light. The skin is cold and covered with clammy per- 
spiration ; the pulse very feeble and almost always rapid, 
— 120 — though it has been known to fall to 40 or 50 a 



THE CARBON COMPOUNDS. 95 

minute ; the respirations are rapid, irregular, and diffi- 
cult, sometimes stertorous, sometimes gasping, and the 
breath has the odor of the acid. Insensibility, coma, and 
collapse follow quickly in succession, and death may 
occur within a few minutes from paralysis of the respira- 
tions, or, if a very large amount has been taken, from 
paralysis of the heart. The average time of death is be- 
tween one and ten hours, and the fatal dose may range 
from 3 i. to 5 ss. 

Treatmeiit of Poisoning. 

In the treatment of this poison emetics are not always 
of use, owing to a paralyzed condition of the stomach, 
and the stomach-pump should be used. The chemical 
antidotes are sulphate of magnesia or of soda, or syrup 
of lime, and they should be freely given ( 3 iii. of the 
sulphates have been given) as long as the patient can 
swallow, or until there is improvement. Lime water and 
milk in equal parts may be given, and vegetable demul- 
cents — as flaxseed tea, but no oils or glycerine, as they 
dissolve the acid and aid its absorption. Atropine is a 
physiological antagonist, maintaining respiration ; and 
cardiac stimulants may be required, given hypodermi- 
cally. 

Carbolic acid is in general use as an antiseptic and 
disinfectant. During operations the instruments are 
kept in a solution of 1 in 30 or 1 in 40, as it does not 
corrode and rust them, in the way that bichloride of 
mercury does. In preparing for an aseptic operation it 
is to be remembered that momentary immersion is not 
enough for the instruments, but they should remain in 
the solution at least ten or fifteen minutes before being 
used. 

Carbolic acid may be used for clothing, as it does not 
stain. In the sick-room its strong odor makes it un- 
pleasant, to many persons, and this odor may be covered 
by using oil of peppermint or cinnamon. 

Dose, TT| i.-iii. (HI x. = gtt. xviii.), in glycerine or 
simple syrup — well diluted. 



g6 MATERIA MEDICA FOR NURSES. 

Crude carbolic acid is used as a disinfectant. 
Sulpho-Carbolate of Sodium. 

A derivative of carbolic acid made by the action of 
sulphuric acid and carbonate of sodium. It is a recent 
preparation, and was composed with a view of obtaining 
the antiseptic and antipyretic action of carbolic acid, 
without its caustic and depressing qualities. It is used 
as an external application, and is given internally. 
Dose, gr. x.-xxx. 

Dobell's solution contains carbolic acid, borax, bicarb, 
of soda, and glycerine. 

Creasote. 

Creasote is produced by the distillation of wood tar, 
and is a very complex substance, containing many hydro- 
carbons, some of which are closely related to carbolic 
acid. Creasote is not as poisonous as carbolic acid, nor 
so active as a germicide and antiseptic, but many of its 
physiological properties are similar, and its value medic- 
inally is about the same, though it is oftener used. 

It is a stimulant, expectorant, and gastric seda- 
tive. In the stomach it checks fermentation, yet does 
not interfere with digestion. The vapor is disinfectant 
and deodorant. When inhaled it is stimulant, and 
when ordered in this way it is convenient to use a small 
cone, which may be easily improvised. 

Only a few cases of poisoning are recorded. The 
symptoms and treatment are like those of carbolic acid. 

Dose, TT[ i.-iii. (TT[ x . = gtt. xx.). 

Aqua Creasoti. 
Creasote Water. 

Strength, i per cent. Dose, 3 i.-iv. 

Acidum Salicylicum (Salicylic Acid). 

Salicylic acid is prepared synthetically by treating a 
solution of carbolic acid in caustic soda with carbonic 



THE CARBON COMPOUNDS. 97 

acid, at a moderate heat. It is also found in nature in 
oil of wintergreen, in sweet birch, and in the bark of 
several varieties of willow. A dull white powder, readily 
soluble in alcohol and glycerine, but almost insoluble in 
cold water. In hot water it is more readily dissolved, 
and borax and boric acid assist the solvent action. 

Physiological Actions. 

Salicylic acid is an antiseptic and disinfectant, i 
part in 60 killing developed bacteria, and a strength of 1 
per cent, preventing their development. It is a diapho- 
retic and antipyretic in fever, but does not lower the 
temperature in health. It is not much used in this way, 
as other antipyretics are more lasting in influence and 
less depressing than salicylic acid. 

After an antipyretic dose there is slight temporary 
stimulation of the heart ; the face and eyes are suffused 
and there is a feeling of warmth, followed by perspira- 
tion. These effects are visible in ten or fifteen minutes, 
and following them there is a reduction of the strength 
of the heart. 

Salicylic acid has a stimulant and disinfectant action 
on the kidneys and urinary apparatus, and increases the 
acidity of the urine. In some cases it irritates the 
kidneys and causes hematuria or albuminuria. 

In small doses it stimulates digestion, the heart, and 
respiration, but in large doses it depresses the two latter, 
lowers arterial tension, and causes nausea and vomiting. 

Incidental Effects. 

In giving salicylic acid the first evidences of over-dosing 
which are to be looked for, are buzzing and roaring 
in the ears, and fulness of the head. Increased doses 
bring severe headache, perspiration, deafness, and various 
disturbances of vision ; and, if still continued, these 
symptoms are all intensified. The respirations become 
deeper and are labored, rapid, and irregular — sometimes 
the most violent respiratory efforts being made to over- 
come the dyspnoea ; the pulse is slow and weak, and 
7 



98 MATERIA MEDICA FOR NURSES. 

there is great restlessness, with a delirium characterized 
by hallucinations of vision, and which is sometimes 
cheerful, sometimes melancholy, and sometimes wildly 
maniacal. The urine may be dark olive-green, and 
involuntary evacuations of the bowels may take place. 

The depression of the circulatory system causes a re- 
laxed state of the skin, and bed-sores are liable to appear 
rapidly. Eruptions of the skin, somewhat resembling 
that of urticaria, may appear even after medicinal doses. 

Salicylic acid is not considered an active poison to 
man. Cases of death from its use have been recorded, 
but they are not all well verified, and poisonous symptoms 
almost always disappear, on the withdrawal of the drug, 
in a few days, or a week. 

Salicylic acid is transformed in the blood into sali- 
cylate of sodium, and is slowly excreted by the urine, 
perspiration, saliva, bile, and mucous secretions. 

Dose, gr. v.- 3 i., moderately diluted. 

Sodii Salicylas. 
Salicylate of Soda. 

Made by the action of salicylic acid on carbonate of 
sodium. It is readily soluble in water ; has the same 
physiological actions as salicylic acfd, and is less irri- 
tating. It has no antiseptic qualities in external use. It 
is considered a specific in rheumatism, and in giving a 
course of it the same incidental symptoms mentioned 
under salicylic acid are to be looked for. 

Dose, gr, v.- 3 i., moderately diluted. 

Salol. 

Salicylate of Phenol. 

A preparation composed of two thirds salicylic and 
one third carbolic acids. It is insoluble in water and is 
given in compressed tablets. 

Salol is antiseptic and antipyretic ; sedative to 
the brain and spinal cord, and with some power as an 
analgesic. It is an active diaphoretic, and though 
in some cases it has a somewhat depressing effect, yet its 






THE CARBON COMPOUNDS. 99 

action is usually not marked by as much exhaustion as 
that of many of the new antipyretics, and when the 
temperature rises after being reduced by salol, it does so 
without chill or chilly feelings. Its physiological effects 
and medicinal uses are in general very like those of 
salicylic acid. It is not considered poisonous, and is, 
like iodoform, used as a topical application. 
Dose, gr. v.-xv. 

OkuT'Gaultheri*. I See 0r S anic Materia Medica - 
Thiersch Powder. 

A combination of salicylic and boric acids, usually 
ordered in the proportion of § ss. of the latter to 3 ss. 
of the former. Added to one quart of water it forms an 
antiseptic solution, of moderate power, which is not 
irritating or poisonous when freely used. The propor- 
tions of a Thiersch powder are not invariable, as Prof. 
Thiersch does not confine himself to one formula. 1 

Naphthalin. 

A coal-tar derivative with the taste and odor of tar ; 
insoluble in water, soluble in ether, hot alcohol, and 
benzol. 

It is antiseptic and destructive to low forms of life. 
Internally it is a stimulant expectorant, and acts as 
a disinfectant to the alimentary canal. The latter 
action is a local one, as it is not readily absorbed into 
the system, but is mostly carried away by the faeces ; 
that part of it taken up by the blood being excreted by 
the urine partly unchanged and partly as naphthol. Ex- 
ternally it is used as an antiseptic. 

Naphthol. 

Derived from naphthalin ; soluble in alcohol, ether, 
chloroform, oil, and vaseline. It is more easily absorbed 
than naphthalin, and causes vomiting, hematuria, con- 
vulsions, and unconsciousness. 

1 Charles Rice, Ph.D. 



IOO MATERIA MEDIC A FOR NURSES. 

It is used as a local application in an ointment of a 
strength of i to 5 for adults, and 2 per cent, for children. 

Hydro-Naphthol. 

A derivative of naphthalin, antiseptic and non-irritant. 
It is claimed that in antiseptic power it stands next to 
bichloride of mercury, and is not poisonous. Soluble in 
cold water in a strength of 1 in 2,000. A saturated 
solution made with hot water has a strength of 1 in 1,000. 
It is used in ointments, strength 1 in 50. It is not in 
general use. 

Creolin. 

Creolin is a coal-tar derivative, from which the poison- 
ous hydrocarbons have been eliminated. It is allied to 
carbolic acid, creasote, etc., but its exact chemical com- 
position is kept secret. It has been introduced as an 
antiseptic, and is used in solutions of 1 and 2 per 
cent., making a milky-looking fluid, as it is not thoroughly 
soluble in water. It has been highly recommended as a 
germicide and antiseptic, but the results in general 
surgery after its use are not always satisfactory. 

Chinolin. 

Chinolin is a derivative of cinchona bark, from which 
it is named, and is also found in coal-tar oil. It is 
made synthetically by the action of glycerine on nitro- 
benzol and aniline. It is a colorless oily liquid, and on 
exposure to the air turns dark. Like an alkaloid, it com- 
bines with acids to form salts. It is antiseptic, and in 
2 per cent, solution prevents the growth of germs. 

The taste and odor are very disagreeable. It resembles 
quinine somewhat in its antipyretic action. After a full 
dose there is a short preliminary stage of excitement, 
with increased pulse and a feeling of warmth, followed 
by perspiration, fall of temperature, slow and weak pulse, 
and lessened respirations. In large doses it diminishes 
reflex action and causes dyspnoea, paralysis, and collapse. 
Only one salt, the tartrate, is used medicinally. 



THE CARBON COMPOUNDS. IOI 

Chinolin Tartras. 

Dose, gr. v.-xx., may be given with peppermint water. 

Chinolin is not in general use, and is here placed be- 
fore some of the more practically important antipyretics 
in an introductory way. Many of these new medicines, 
which are synthetically prepared in laboratories, are the 
results of experiments made in the attempt to produce 
an imitation of quinine, and different ones are derived 
from chinolin. 

Antipyrin. 

Antipyrin is a coal-tar derivative, being prepared from 
chinolin. It is an alkaloidal body, combining with acids 
to form salts. A whitish, crystalline powder of slightly 
bitter taste, soluble in water in a proportion of ten parts 
to six parts of water. 

Physiological Actions. 

When first introduced it was a proprietary medicine 
and was known principally as an antipyretic. With 
further use and investigation other therapeutic qualities 
have been manifested. 

It is a general nerve sedative and anodyne, having 
a considerable degree of power in the relief of pain in 
various conditions of nervous origin. It is slightly 
antiseptic and disinfectant, diaphoretic, and has 
some diuretic action. It is also credited with being to 
some extent a haemostatic. Antipyrin does not lower 
the normal temperature, but in fever its action is very 
marked. There is a short period of stimulation, with 
flushing of the face, a feeling of heat, and increased 
action of the heart. In about half an hour or more per- 
spiration breaks out and usually becomes very profuse. 
The pulse is then slowed, but not always weakened. 
The skin is cool ; there may be chilly feelings, and the 
temperature falls from one to several degrees, according 
to the amount taken, and remains down for a length of 
time, also proportioned to the dose — usually two or three 
hours, and often longer. 



102 MATERIA MEDIC A FOR NURSES. 

There results very often — especially in subjects weak- 
ened by a long illness — a decided state of depression, 
sometimes so marked as to be alarming, and the pulse, 
though not always weakened, is in some cases seriously 
so. The use of antipyrin in acute illness often causes 
nausea and vomiting, though it is not a gastric irritant 
in any special sense, but in small doses tonic, increasing 
the appetite. Symptoms which indicate danger in giving 
antipyrin are cyanosis, muscular weakness, disturbed 
and rapid respirations, weakened irregular pulse, 
dyspnoea, and sensations of heat over the body. Col- 
lapse may result from its use, and death in one instance 
followed the administration of fifty odd grains. An 
eruption of the skin frequently occurs, with some con- 
stitutional disturbance and considerable suffering and 
annoyance from the itching, which is severe. It lasts for 
several days, and in the majority of cases resembles the 
measles rash ; but sometimes appears as a general and 
intense erythema, with swelling of the face, especially 
about the eyes, burning sensations, and rise of tempera- 
ture. Antipyrin has been given hypodermically, but is 
irritant and liable to cause abscesses. If so given it 
should be injected deeply into the gluteal muscular 
tissue. 

Dose, gr. v.-xx., diluted moderately. It may be given 
in a little wine, or iced brandy and water ; and to chil- 
dren, in syrup. 

Antifebrin (Acetanilid). 

A neutral substance derived from anilin by the action 
of glacial acetic acid. A colorless crystalline powder of 
slightly burning taste, soluble in alcohol, but not readily 
so in water. 

Its medicinal qualities are very similar to those of 
antipyrin, it being antipyretic, analgesic, and a ner- 
vous sedative. It has some differences of action. It 
diminishes the irritability of sensory nerves, lessens the 
reflex action of the spinal cord, raises arterial tension to 
some extent, and slows the heart correspondingly. The 






THE CARBON COMPOUNDS. I03 

reduction of temperature by acetanilid takes place rather 
more slowly than that caused by antipyrin — sometimes 
twice as much time being required. 

The effects last longer — six or seven hours — and the 
fall is sometimes, though not always, accompanied by 
perspiration rather less profuse than that produced by 
antipyrin. The lowering of the temperature is not sup- 
posed to depend on this diaphoresis, as experiments 
show that one sometimes follows without the other. 

The antipyretic action of acetanilid is occasionally 
followed by cyanosis, and in rare cases by collapse, 
though it is usually considered less apt than antipyrin to 
produce severe depression, and in the majority of cases 
its use leaves no ill after-effects and does not nauseate. 
It has diuretic action and is a cerebral stimulant, while 
antipyrin depresses the brain. A poisonous dose de- 
stroys the ozonizing function of the blood. 

Incide?ital effects noticed sometimes after its use are 
deafness, ringing in the ears, dilatation of the pupils, and 
an eruption similar to that caused by antipyrin. 

Dose, gr. v.-xv. It may be given in dilute alcoholic 
solution, and, like many remedies to-day, is put up in 
compressed tablets. 

Resorcin. 

Resorcin is obtained from galbanum, a resin, by the 
action of alkalies. It is also made from carbolic acid, 
thus belonging to the phenol group or derivatives of coal 
tar. It occurs as white crystals with an odor resembling 
carbolic acid, and is soluble in water, and also in 
alcohol. It is antiseptic and disinfectant, inferior, 
however, in these respects to carbolic acid. It has con- 
siderable antipyretic action, in large doses, causing 
free diaphoresis with reduction of the pulse and tem- 
perature. The pulse may, within an hour, be slowed by 
as much as one third its former number of beats, and the 
temperature fall three or four degrees, to remain down 
for from two to four hours, when it rises again rapidly. 
While rising there may be chilly feelings, or a distinct chill. 



104 MATERIA MEDIC A FOR NURSES. 

Doses which produce these results, viz., gr. xxx.-lx., 
cause also, as preliminary symptoms, dizziness, ringing 
in the ears, frontal headache, trembling, and quickened 
respirations. With the breaking out of perspiration 
these disturbances die away. No fatal case of poisoning 
is known. In one case, where 120 grains were taken, 
giddiness, and a feeling as of the pricking of pins came 
on immediately. Unconsciousness followed, with sub- 
normal temperature and thready pulse. 

The chief action of resorcin is upon the nerve centres, 
and it has been shown experimentally that very large 
doses paralyze the heart. 

Dose, gr. ii.-v. 

It is used in an ointment, strength from 5 to 30 per 
cent. 

Pheno-Resorcin. 

A mixture of carbolic acid and resorcin, in the pro- 
portion of two thirds of the former and one third of the 
latter. Its qualities have not been thoroughly tested. 

Phenacetine. 

A new preparation belonging to the phenol group ; a 
decided antipyretic, being also antiseptic, sedative, 
and analgesic. After large doses profuse sweating is 
the first result, appearing in from thirty to fifty minutes, 
and in one or two hours the temperature begins to fall, 
reaching its lowest point in about four hours. The 
reduction is quite marked, averaging about 3 , while a 
fall of 5 or 6° has been known. Some depression may 
follow — not severe enough usually to be alarming, — with 
weak and chilly feelings and weakened pulse. The rise 
of temperature is more gradual than the fall. In com- 
parison with the activity of other antipyretics, ten grains 
of phenacetine are said to equal fifteen grains of antipy- 
rin or quinine, and thirty grains of salicylate of soda, 
and to be equal in power with antifebrin, though less rapid 
in action and more enduring in its effect. 

An eruption of the skin sometimes occurs in anaemic 
patients. 



THE CARBON COMPOUNDS. 105 

Phenacetine is almost insoluble in water, and is given 
dry on the tongue, or in compressed tablets, or capsules. 
Dose, gr. iii.-x. 

Exalgine. 

A preparation introduced by French physicians, de- 
rived from acetanilid. It has analgesic power, and the 
name was given with reference to this quality, and does 
not describe its chemical constitution, as do many of the 
names of new remedies. It is hypnotic and anodyne 
and comparatively free from ill after-effects. 

Its action in the relief of pain is rapid. In some cases, 
dizziness, trembling, weakness of the "knees, and loss 
of muscular power in the eyelids have appeared almost 
immediately after its administration, passing off in a 
short time. 

It is given dry on the tongue, in powder or m tablets. 

Dose, gr. v.-x. 

Hydroquinone and Pyrocatechin. 

Synthetic alkaloids, made in imitation of quinine, and 
resembling it in chemical constitution, while in physio- 
logical actions they are similar to resorcin. 

They have some antipyretic and antiperiodic qualities, 
but for all practical purposes they are inferior to quinine, 
and are little used. 

Kairin and *Kairolin. 
Thallin and Acetphenetidin. 

Synthetic alkaloids of coal-tar derivation, resembling 
quinine more or less in chemical composition and in 
antipyretic action. They are all depressing to the heart 
and nervous system, and are only used experimentally. 

Pyridine. 

Pyridine is found in nature as one of the principles of 
tobacco-juice, and is imitated in chemistry, and derived 
from chinolin. It is a volatile liquid with strong aro- 



106 MATERIA ME DIC A FOR NURSES. 

matic odor. It gives off, at ordinary temperatures, a 
vapor which is used medicinally, having a stimulant 
effect on the respirations and on the spinal cord. On 
the heart it has an influence resembling that of digitalis, 
increasing the strength of the systole. 
Dose, TTlv.-xx. 

Saccharin. 

Saccharin is a substance produced by a very complicated 
chemical process from a coal-tar product called toluene. 
It is the sweetest of known substances, being between 
two hundred and three hundred times sweeter than 
sugar, but in chemical constitution it is an acid. 

It is not a food, like sugar, nor a medicine, as it has 
no special effect on the system. It may be used instead 
of sugar in diseases where sugar is forbidden, and may 
also be combined with quinine, the bitter taste of which 
it entirely disguises. 

It has antiseptic power. 

Oleic Acid. 

A fluid fatty acid made from olein, the fluid principle 
of oils and fats, by the action of heated steam. It is 
used in the preparation of medicinal ointments called 
oleates, two of which are o^fncinal, the oleate of veratrum 
viride, strength 2 per cent., and the oleate of mercury, 
strength 10 per cent. 

The oleate of zinc is also used. 

Petrolatum. 

Vaseline. 

Vaseline is a semi-solid substance obtained from petro- 
leum by distillation and purification. It is the simple 
ointment of the pharmacopoeia, and is used alone as an 
emollient, and also as the basis of various ointments. 



THE CARBON COMPOUNDS. I07 

Glycerinum (Glycerine). 
Propenyl Alcohol. 

Glycerine is obtained by the reaction of fats and 
fixed oils with watery alkaline fluids. Chemically it is 
classed with the alcohols. It is always set free in the 
process of soap making as a waste product, and so made 
is purified and sold, though the larger part of the 
glycerine in commerce is manufactured directly by the 
decomposition of fats by heated steam. 

Glycerine absorbs water from the air and mixes with 
water in all proportions. If pure it cannot become 
rancid. 

Applied externally it is unirritating to the sound skin, 
but painful if there are any abrasions. 

It is slightly stimulant and antiseptic, and tends to 
make the skin dry and brittle. It is readily absorbed 
when applied externally. 

Internally it has no special effect on the stomach, but 
is supposed to have some nutritive power. It is produced 
normally in the intestines during the digestion of oils and 
fats. If administered in free doses it has a laxative 
action, and for this purpose is given alone, or in com- 
bination with castor oil, in doses of § ss.-i. 

The laxative action is very notable when glycerine is 
administered as an enema ; a small amount — § ss.-ii. — 
acts quickly and satisfactorily. 

Glycerine suppositories, lately introduced, are also, in 
most instances, very efficacious. 



PART II. 

THE ORGANIC MATERIA MEDICA. 

THE VEGETABLE KINGDOM. 



Arranged under Botanical Divisions or Natural Orders. 



Nat. Ord. Ranuncidacece. 
Aconitum (Aconite). 

Monk's-hood, Wolfsbane. 

Aconite is a tall perennial plant bearing a spike of 
blue flowers ; found native in Europe, and cultivated in 
the United States. The officinal portion is the root, 
which is from 3 to 4 inches long, about f inch in 
diameter at the base, and tapers to a fine point. It is 
brown in color, externally, and has been mistaken for 
horse-radish, but the latter is whitish, does not taper 
gradually but has almost the same diameter for several 
inches, and has a strong odor when scraped, which 
aconite root has not. 

There are several varieties of the plant, all more or less 
poisonous. 

Physiological Actions. 

Aconite applied locally to the skin or mucous mem- 
brane acts on the terminations first of the sensory and 

108 



THE VEGETABLE KINGDOM. IO9 

next of the motor nerves, as a depressant or sedative, 

and causes tingling followed by numbness and insensi- 
bility. 

Taken internally aconite is sedative to the heart and 
respirations ; is diuretic and diaphoretic, and reduces 
temperature. It has no effect on the brain. Me- 
dicinal doses, given close together, reduce the frequency, 
force, and tension of the pulse, produce a gentle per- 
spiration, and increase the amount of urine. Respiration 
becomes slower and deeper ; the temperature falls. The 
tendency of the pulse under the influence of aconite is 
to become small, compressible, and weak. 

Larger doses, or a single full medicinal dose, produce a 
tingling feeling, usually first noticeable in the lips or ex- 
tremities : or, if the impression be decided, the tingling 
may be felt over the whole body. 

There may be also a raw, irritable, or constricted feel- 
in the throat, and difficulty in swallowing, caused by 
anaemia of the throat. There is muscular weakness ; 
giddiness and disorders of vision may be produced, 
especially if any exertion is made ; the respirations are 
diminished, and the pulse may fall to 30 or 40 a minute. 

The first effects of medicinal doses are usually shown 
in half an hour, and the symptoms mentioned will pass off 
in three or four hours. After poisonous doses, if large, 
death may occur immediately from instant paralysis of 
the heart-muscles ; or the symptoms may come on in a 
few moments and death occur soon after, the average 
time being between three and four hours. 

Symptoms of Poisoning. 

The first symptom of poisoning is the characteristic 
tingling, which is diagnostic of every variety and prep- 
aration of aconite. 

The pulse fails rapidly, becoming weak, irregular, in- 
termittent, and slow ; the respirations are shallow, weak, 
and sighing, irregular and slow. There is anaesthesia of 
the surface and great muscular weakness ; the tongue 
and breath are cold ; the skin covered with a cold sweat. 



IIO MATERIA MEDIC A FOR NURSES. 

The face has an anxious look and is sunken and livid. 
The eyes are glaring, the eyeballs protruding ; the pupils 
are generally dilated. The voice is suppressed. There 
may be vomiting, although it does not always occur. 
The mind usually remains clear, but there are sometimes 
convulsions, and in these cases stupor and unconscious- 
ness may be present. In the latter stages of collapse the 
special senses may be lost, especially the sight. 

Treatment of Poisoning. 

The first thing necessary is to empty the stomach and 
wash it out with the stomach-pump. Hot and concen- 
trated alcoholic stimulants are given ; external heat ap- 
plied ; the patient's head lowered beneath the line of his 
feet by taking out the pillows and elevating the foot of 
the bed ; and absolute quiet and rest maintained. 
Artificial respiration may be practised, and cardiac 
stimulants given hypodermically. 

Atropine is a physiological antagonist, stimulating 
respiration, and ammonia has the same effect. Digitalis 
counteracts the depression of the heart, but acts slowly, 
while aconite is exceedingly rapid in action. 

Precautions. 

The pulse should always be taken before giving a dose 
of aconite, and respirations and temperature watched. 
Any possibility of cold air or draughts must be guarded 
against, the skin being relaxed, and no exertion on the 
part of the patient — such as sitting up in bed — allowed. 

Preparations of Aconite. 

Abstractum Aconiti. 

Made from the root. Dose, gr. i. 

Extractum Aconiti. 

Made from the leaves. Dose, gr. J— J. 

Extractum Aconiti Fluidum. 

Dose, TU i.-ii. (TT[ x. = gtt. xxv.). 






THE VEGETABLE KINGDOM. Ill 

Tinctura Aconiti. 

Made from the root. Strength, 40 per cent., or § vss. 
in Oj. Dose, TTl i.-iv. (TT[ x . = gtt. xxv.), in water. 

Fleming's Tincture of Aconite. 

Made from the root. Strength, 79 per cent., or § xss. 
in Oj. Dose, TT[ ss.-ii., in water (fll x. = gtt. xxv.). 
Aconitine. 

An alkaloid or active principle obtained from aconite. 
Dose, gr. ^ 
Aconitinae Oleatum. 

For external use, strength 2 per cent. St. Jacob's oil, 
a quack medicine, contains aconite. 

Staphisagria (Stavesacre). 

The dried ripe seeds of delphinium staphisagria. 
They possess four alkaloids, one of which, delphinine, 
is closely allied to aconitine, resembling it strongly in 
action. It is even more depressing. The only use of 
staphisagria is as a parasiticide. The preparation for 
this purpose is called delphine. 

Podophyllum (May Apple ; Mandrake). 

The dried rhizome 1 and rootlets of the May apple, a 
perennial herb of the Northern and Middle United 
States. An alkaloid, berberine, and two resins, are the 
active principles. 

Physiological Actions. 

Podophyllum is an active cathartic, with chola- 
gogue properties. Its actions are shown not only when 
taken internally, but also when applied to a broken sur- 
face or given hypodermically. It has a bitter acrid taste, 
and causes slight salivation, irritation of the stomach, 
nausea, and griping pains. In large doses it causes 
severe colic. The purgative action is very slow, requir- 
ing ten hours or more, and is due to stimulation of the 

1 Root stock. 



112 MATERIA MEDIC A FOR NURSES. 

intestinal glands and of the muscular coats of the in- 
testine ; also to a stimulant action on the liver, with a 
decided increase in the flow of bile. 

In large quantities it may cause poisoning. Cases of 
poisoning in children have happened, with vomiting, 
purging, epileptiform convulsions, coma, and collapse. 

Preparations. 
Extractum Podophylli. 

Dose, gr. i.-iii. 
Resina Podophylli. 

Dose, as a laxative, gr. y 1 ^. 
Resina Podophylli. 

Dose, as a purgative, gr. \-\. 
Extractum Podophylli Fl. 

Dose, TTj, v -xv. (fTi x. = gtt. xii.). 

Podophyllum used externally is irritant, and may 
inflame the eyes if carelessly handled. 

Cimicifuga (Black Snakeroot). 

The dried rhizome and rootlets of cimicifuga race- 
mosa, an indigenous plant, containing a volatile oil, two 
resins, and tannin. 

Cimicifuga has antispasmodic action. In moderate 
doses it has been used as a stomachic and cardiac tonic, 
and it increases somewhat the action of the skin and 
kidneys. In large doses it slows the heart, and raises 
blood-pressure, acting like digitalis, and in excessive 
doses it produces giddiness, severe headache, and pros- 
tration. No cases of poisoning are known. The prep- 
arations should not be kept long, as they spoil with age. 

Preparations. 

Extractum Cimicifugae Fl. 

Dose, TT[ xx. - 3 i. (m x. = gtt. xii.). 
Tinctura Cimicifugae. 

Dose, 3 i.-ii. 



THE VEGETABLE KINGDOM. 113 

Adonis Vernalis. 

The root of Adonis vernalis contains a glucoside 
named adonidine. It is allied in action to digitoxin, one 
of the principles of digitalis, but is more powerful and 
irritating to the digestive organs. 

Physiological Actions. 

Adonidine stimulates the heart and vaso-motor cen- 
tres, acting more promptly than digitalis. It is not cumu- 
lative in tendency. It has no special power as a diuretic, 
though there may be some slight action resulting from 
the effect upon the circulation in the kidneys. 

In overdoses adonidine produces vomiting and diar- 
rhoea. 

Preparations. 

Adonidine. 

Dose, gr. \. 
Infusion of Adonis Vernalis. 

Strength, 3 ss.-ii. of the root to f vi. 

Nat. Ord. Menispermacece. 
Calumba. 

The root of jateorrhiza calumba, of Eastern Africa, 
contains an alkaloid, berberine ; a bitter neutral principle, 
colombin ; and colombic acid. It contains no tannin, 
and may be given with iron. 

Calumba is a bitter tonic and stomachic, stimulating 
the flow of saliva, the glands and blood-vessels of the 
stomach, and also the gastric nerves, causing a sensation 
of hunger. Calumba, like bitters in general, has some 
power to overcome fermentation or decomposition in the 
stomach and intestines ; promotes peristalsis ; (bitters 
containing tannin have not this property) removes flatu- 
lence and tends to regulate the evacuation of the bowels. 

Bitters if given in excess or for a long time, irritate 
8 



114 MATERIA ME DIC A FOR NURSES. 

the stomach and bring on indigestion. Calumba is one 
of the least irritating of this class of medicines. 

Like all bitter stomachics it must be given well diluted, 
and about half an hour before meals. 

Tinctura Calumbae. 

Strength i to 9. Dose, 3 i. — il- 
Extractum Calumbae Fluidum. 

Dose, fT[ xv.- 3 ss. (fT[ x. = gtt. xiv.). 

Picrotoxin. 

The fruit (called fish berries) of anamirta paniculata, 
an Asiatic plant, yields an active principle, picrotoxin, a 
bitter neutral substance. 

It is an active excitant of the brain and spinal cord ; 
stimulates secretions, especially of the intestines ; causes 
nausea and vomiting, and slows the heart and respira- 
tions. In overdoses it produces muscular twitchings, 
stupor, delirium, convulsions, and coma ; and may cause 
death by paralysis of the heart. 

The temperature is slightly raised by picrotoxin. 

It has been used externally in an ointment, and con- 
vulsions and death have followed its use in this way. 

Preparations. 

Picrotoxin. 

Dose, gr. jVsV, in pill. 

Nat. Ord. Papaveraccce. 
Opium. 

Opium is the juice of the unripe capsules of the 
papaver somniferum or white poppy, thickened by evap- 
oration (inspissated), and is obtained by incising the 
capsules with a small sharp knife, when the juice flows 
forth, and hardens into a semi-solid mass. It is produced 
chiefly in Turkey, Asia Minor, Persia, and India. 

That used in the United States is almost all brought 
from Asia Minor ; is called Smyrna or Turkey opium, 
and contains from 10 to 12 per cent, of morphine. 



THE VEGETABLE KINGDOM. 115 

When dried and powdered, opium is yellow brown in 
color, and dissolves in water, alcohol, and dilute acids. 

Opium is an exceedingly complex substance, contain- 
ing the alkaloids morphine, codeine, narceine, narcotine, 
thebaine, papaverine, porphyroxine, cryptopine, meco- 
nine, opianine, and paramorphine ; meconic, thebolactic, 
and sulphuric acids ; fixed oils, odorous principles, ex- 
tractives, gum, resin, salts, glucose, and other unim- 
portant substances, with about 16 per cent, of water. 

Physiological Actions. 

Opium is generally considered to be anodyne and 
anaesthetic when applied to the unbroken skin, yet some 
authorities consider this doubtful, and attribute any good 
effect from such application to the moist heat or to the 
resins and spirits of the liquid preparations. Mucous 
surfaces, wounds, ulcers, etc., readily absorb opium. 
The local action of the drug is astringent. In the 
mouth the mucous lining is dried, the tongue coated, 
and a sensation of thirst produced. In the stomach 
opium may cause a short period of irritation of the 
nerves, with nausea, but soon sensibility is diminished, 
the secretions checked, sensations of appetite and hunger 
are lost, the digestive powers fail, and the afferent nerves 
are depressed, so that the act of vomiting is produced 
with difficulty, and direct emetics may fail altogether. 

In the intestines opium is sedative and astringent. 
All impressions given to the nerves from the mucous 
membrane are weakened ; the secretions are diminished, 
peristaltic action is checked, and pain relieved. 

Given by the rectum, as in enemata or suppositories, 
opium allays local pain, checks diarrhoea, and acts as an 
antispasmodic, keeping the parts at rest, and preventing 
irritability of the mucous membrane. 

The secretion of bile is diminished and the urine les- 
sened in quantity. The bowels are constipated. The 
skin is the only organ whose action is not decreased by 
opium. Perspiration, instead of being lessened, is ex- 
cited, especially by some preparations, which are de- 
cidedly diaphoretic. 



Il6 MATERIA MEDIC A FOR NURSES. 

Opium is eliminated by the breath, perspiration, urine, 
and milk. The latter is to be remembered in giving 
opium to a nursing mother. 

The pre-eminent influence of opium is upon the brain 
as a stimulant, hypnotic, and narcotic. These actions 
are more prominent in man than in animals, and in 
highly civilized than in lower races. 

The stimulant effect is noticeable sometimes after a 
medicinal dose, and precedes the hypnotic action by a 
short variable period. In persons who are accustomed 
to large doses of opium the period of stimulation is more 
marked. The nerve centres which preside over the 
imagination are specially affected. The imaginative 
powers are heightened and the will power weakened. 

Opium also acts upon the heart as a stimulant, sustain- 
ing and strengthening it. The opium .pulse resembles 
the healthy pulse, being strong, moderately slow, and 
regular ; full, compressible, and of moderate length, and 
is not disturbed by change of position, exercise, or men- 
tal agitation — an important difference between the action 
of opium and other cardiac stimulants.' 

The anodyne effects of opium depend chiefly on 
morphine, its most important alkaloid. There are some 
differences of action between opium and morphine alone, 
as follows : opium is less soluble than morphine, is more 
slowly absorbed, and the effects last longer ; its local 
action on the intestines is more pronounced ; it reaches 
the bowels directly and is more constipating. For 
this reason it is preferred in many cases of intestinal 
trouble. 

Opium is not as powerful a narcotic as morphine, as 
several of its other alkaloids (thebaine, codeine, and nar- 
cotine) have a more or less exciting or convulsant action 
which modifies the whole drug. 

Opium disorders the digestion more than morphine 
and has greater power as a diaphoretic. 

Finally, opium, being of variable strength, is not as 
reliable as morphine, the quantity of which in a given 
dose may be accurately determined. The relative 
strength of opium to morphine is about as \ or ^ to i. 



THE VEGETABLE KINGDOM. 117 

Symptoms of Poisoning. 

The mildest manifestation of opium on the brain is a 
quiet dreamy state ending after a short time in sleep, 
either light and natural or heavy, and passing into stupor 
according to the size of the dose. There is hyperemia x 
of the brain in the sleep caused by opium. On awaken- 
ing there may be slight depression with headache and 
languor, caused by imperfect aeration of blood — which is 
in turn the result of diminished respirations — and lasting 
several hours. There may be nausea, or even vomiting, 
or the patient may return at once to the normal condi- 
tion. This is the first stage of opium narcosis. After 
large doses the second stage comes on quickly, or at 
once. The symptoms of this condition are very like 
those of congestion of the brain. 

The pupils are contracted, the face flushed, often 
cyanosed ; the pulse is full, slow, and strong ; the respi- 
rations slow and deep, sometimes stertorous ; the skin is 
usually dry and warm, and unconsciousness is apparently 
complete, though the patient can usually be roused, and 
if so, the* breathing becomes more rapid and the face 
regains its natural color. There is usually retention of 
urine. Death does not often occur in this stage of opium 
narcosis. 

The third stage is that of prostration with profound 
coma, from which it may be impossible to rouse the 
patient ; but, if he can be roused and made to speak, his 
answer, though it may not be complete, will be rational, 
and there will be no thickness or indistinctness of artic- 
ulation, as there is in alcoholic poisoning. This is 
characteristic of opium poisoning. The respirations are 
weak, shallow, irregular, and slow ; they may fall to one 
or two in a minute, while in the second stage they may 
frequently be found as low as four or five. The face is 
pallid and cyanosed ; the skin cold and covered with 
perspiration ; the pupils are absolutely contracted, and 
just before death they dilate widely. The pulse becomes 

1 An excess of blood ; the opposite condition to that found in nor- 
mal sleep. 



Ho MATERIA MEDICA EOR NURSES. 

more and more rapid and weak, and death results from 
failure of the respirations. 

Treatment of Poisoning. 

The treatment of opium poisoning is mainly directed 
toward maintaining respiration, and in those cases where 
symptoms of narcotism arise gradually after the giving of 
medicinal doses, it is enough simply to work toward this 
one object, by rousing the patient and trying to keep 
him roused until the effects wear away of themselves. 
Naturally, in the case of narcotism after hypodermic 
injections, emetics would be useless. Alcoholic stimu- 
lants may be given hypodermically, and black coffee, as 
strong as possible, given through a tube into the stomach, 
if necessary, or by rectum, as it will sometimes be diffi- 
cult to make the patient swallow. 

In those cases where a large dose has been taken by 
mouth, the stomach must be emptied. A tablespoonful 
of mustard in a glass of warm water may be given, and 
repeated in ten minutes, and gr. xxx. each of ipecac and 
sulphate of zinc maybe afterwards given and repeated 
once or twice at intervals of fifteen minutes, with plenty 
of warm water. If emetics refuse to act on the torpid 
stomach, the stomach-pump must be used, but, though it 
acts better than emetics when fluid preparations have 
been taken, it is useless if the solid drug has been used. 

After washing out the stomach respiration must be 
supported in every possible way, yet measures which may 
exhaust the patient's strength are to be avoided. Black 
coffee is given as before mentioned. Cold or alternate 
hot and cold douches may be applied to the head and 
chest. Artificial respiration should be kept up untir- 
ingly, for hours if necessary, or the battery may be used. 

The bladder must be emptied by the catheter, to 
prevent re-absorption, and the temperature kept up by 
the application of external heat. 

Various cardiac and respiratory stimulants are given 
hypodermically ; atropine is a physiological antagonist to 
the action of opium on respiration, being the most active 



THE VEGETABLE KINGDOM. 1 1 9 

known respiratory stimulant ; but it is necessary to regu- 
late the amount given with great precision and with a 
thorough understanding of the entire physiological rela- 
tion of one to the other. Lacking this, it would probably 
be given rashly, and atropine poisoning be added to the 
opium narcosis. For this reason the administration of 
atropine should not be undertaken except under direc- 
tions from a physician. 

There are usually no sequels to opium poisoning. 
The amount which may cause death varies greatly with 
idiosyncrasy or the habits of the patient. Recovery has 
taken place after 55 grains of solid opium and again after 
6 ounces of laudanum had been taken, while 4 grains of 
crude opium have caused death. 

Incidental Effects of Opium. 

Idiosyncrasies are very common in regard to opium, 
especially among delicate nervous women. Severe de- 
pression sometimes follows ordinary doses, marked espe- 
cially by excessive vomiting. In these cases, nausea is 
not felt while the patient is lying down, but recommences 
on rising. Delirium sometimes follows, or retention 
of urine. A common result, noticed when the effects of 
a dose are wearing off, is an itching, sometimes general, 
sometimes confined to the face and especially the nose ; 
and erythema — red stains or blotches, appear on the 
face. Children and old people bear opium badly. With 
children this is accounted for by the disproportionately 
large size of brain ; and women are more susceptible to 
its action than men. 

In conditions where there is severe suffering, much 
larger doses than ordinary can be safely taken, for the 
power of the drug then seems to be spent in overcoming 
the pain. 

Preparations of Opium. 

According to the Pharmacopoeia of 1880 all the liquid 
preparations of opium, except paregoric, are required to 
be made in a strength of 10 per cent, opium. 



120 MATERIA MEDICA FOR NURSES. 

Solid Preparations. 

Opium Denarcotisatum. 

Opium which has been deprived of its narcotine by the 
action of ether. Narcotine is not a narcotic in action. 
Dose, gr. J-i. 

Extractum Opii. 

Double strength. Dose, gr. J-i. 
Pilulae Opii. 

It is to be remembered that opium pills, if old, are dry 
and hard to dissolve, and if given in succession may pro- 
duce alarming symptoms by accumulating in the alimen- 
tary canal and dissolving all at once. 

Liquid Preparations. 

Tinctura Opii Camphorata. 
Camphorated Tincture of Opium. 
Paregoric. 

Contains gr. ii. of opium to § i. ; also benzoic acid, 
oil of anise, and camphor. Owing to the camphor it is 
more constipating than the other preparations. 

Dose for an adult, 3 i- § ss. ; for a baby under one 
year, TT[. i.-y. ; for a child under two years, "fil. v.-xv. ; 
under three years, TT[. v.-xx. ; under four and five years, 
Tf[. v.-xxv. ; under ten years, HI. xx.-xxx. ; under fifteen 
years, TIL xxx.- 3 i.-ii. 

(TT[ x. of paregoric equal gtt. xx. and gr. ^V of opium.) 
Tinctura Opii Deodorata. 
Deodorized Tincture of Opium. 
McMunn's Elixir. 

Contains no narcotine and none of the odorous prin- 
ciples, and is therefore less nauseating than laudanum. 
Dose, TU. x.-xv. (TTJ, x.-gtt. xvii. One grain is represented 
by twelve minims). 
Tinctura Opii. 
Tincture of Opium. 
Laudanum. 

Dose, TT[. x.-xv. (ni. x. = gtt. xx.). 



THE VEGETABLE KINGDOM. 121 

Tintura Opii Acetata. 
Tincture of Acetate of Opium. 

Dose, TTj,. x.-xv. (y\. x. = gtt. xv.). 
Tinctura Opii Composita. 
Squibbs' Diarrhoea Mixture. 

Contains in f v. | i. of opium and also tr. capsicum, 
spirits of camphor, chloroform, and alcohol. 

Dose, Til. x. (HI. x. = gtt. xiv.). 

Other Preparations Containing Opium. 
Pulvis Ipecacuanha et Opii. 
Ipecac and Opium Powder. 
Dover's Powder. 

One powder of ten grains contains gr. i. of opium, gr. i. 
of ipecac, and gr. viii. of sugar of milk. An excellent 
diaphoretic, though somewhat nauseating. 

To be taken at night. Dose, gr. v.-x. 

Emplastrum Opii. 
Opium Plaster. 

Composed of extract of opium, Burgundy pitch, and 
lead plaster. 
Opium and Lead Wash. 

Composed of acetate of lead, gr. cxx., tincture of 
opium, | ss., and water, § xvi. 

Alkaloids of Opium. 
Morphinae (Morphine). 

The officinal salts of morphine in dry form are as 
follows : 

Morphinae Acetas. 
Acetate of Morphine. 

A white bitter powder, soluble in water in a strength of 
i to 12 ; made from the hydrochlorate of morphine by 
the action of acetic acid. 
Morphinae Hydrochloras. 
Hydrochlorate of Morphine. 

Made by the action of hydrochloric acid ; soluble i 
part in 24 parts of water. 



122 MATERIA MEDIC A FOR NURSES. 

Morphinae Sulphas. 
Sulphate of Morphine. 

Made by the action of sulphuric acid. Soluble i part 
in 24 parts of water. 

The dose of all these salts in solution is gr. \-\. 

Liquid Preparations of Morphine. 

Liquor Morphinae Sulphas. 
Solution of Sulphate of Morphine. 

Contains gr. i. of morphine to J i. Dose, 3 i.-ii., di- 
luted only slightly with water. 

Magendie's Solution of Morphine. 

This preparation is not officinal ; it contains gr. xvi. of 
morphine to \ i., and it is used almost entirely hypo- 
dermically. If it is old, or exposed to the air, it devel- 
ops a fungus which unfits it for use. It is not irritating 
to the tissues. 

The analgesic and narcotic action of morphine is 
quickly manifested, coming on usually within half an 
hour after an ordinary dose, sometimes in a few mo- 
ments. The length of time during which these effects 
last varies much with the condition of the patient, the 
degree of pain present, and the extent of toleration of 
the drug which has been established. The average may 
be put at four or five hours, (ill. x. = gtt. x.) 

Codeina (Codeine). 

Codeine has slightly exciting action on the spinal 
cord. Its hypnotic action is feeble and uncertain. It is 
not constipating. 

Dose, gr. |-i., usually in pill. 

The other alkaloids of opium resemble morphine 
somewhat, but are not used in medicine. 

Narcotine is wrongly named, as it has no narcotic 
power, and on animals acts as a tetanizer. 

Thebaine is a convulsant, almost like strychnine. 



THE VEGETABLE KINGDOM. 1 23 

Apomorphinae Hydrochloras. 

Prepared from morphine by the action of hydro- 
chloric acid. An active and certain emetic, which 
acts indirectly or through the vomiting centre in the 
medulla. It may therefore be given hypodermically if 
the patient is unable to swallow. In from five to twenty 
minutes it causes nausea and repeated vomiting. 

If taken by the stomach it does not irritate, and leaves 
no ill after-effects. Very large doses cause prostration 
and paralysis of the voluntary muscles and depression of 
the respiratory centre. 

Small doses are expectorant, but it is not much used 
in this way. 

Expectorant dose, gr. to - tV 

Emetic dose, gr. \. 

Emetic dose, hypodermically, gr. T V every 10 minutes. 

Emetic dose, hypodermically,for an infant, gr. -^"tV 5 
and for a child of 10 years, gr. ^ ir . 

Nat. Ord. Crucifercs. 
Sinapis (Mustard). 

The mixed and powdered dried ripe seeds of brassica 
alba and brassica nigra, grown in temperate regions. 

Black mustard seeds contain various principles, the 
most important one being a volatile oil, oleum sinapis, 
which is set free when water is added. 

It is a pale-yellow or colorless fluid, of intensely pun- 
gent and penetrating odor, burning taste, and a blister- 
ing and corrosive action on the skin. 

White mustard seeds do not possess this volatile oil, 
but contain a rubefacient principle which resembles it, 
and which is set free in the same way on the addition of 
water. 

Physiological Actions. 

Applied externally, as in poultices, baths, etc., mus- 
tard is a nerve stimulant, rubefacient, and vesicant, 
causing redness, heat, and severe burning pain, and, if 



124 MATERIA MEDIC A FOR NURSES. 

long applied, blistering. Relief of previous pain and 
loss of sensibility to other impressions follow the action 
of mustard. The heart, blood-pressure, respirations, and 
nerve centres generally are first stimulated, then quieted, 
and, if vesication has resulted, depressed, even seriously. 
In baths, mustard dilates the vessels of the skin and re- 
lieves the blood-pressure in congested organs. 

The principles of counter-irritation are, first : that, by 
causing dilatation of the vessels of that part to which ap- 
plication is made, there is contraction of the vessels in 
other parts of the body, especially if there is nervous 
connection between the two ; and following this principle, 
counter-irritants are usually applied at some distance 
from the congested part, as in the use of foot-baths ; 
second, that, by increasing the activity of the circulation, 
counter-irritants promote the re-absorption of inflamma- 
tory products, and for this purpose they are sometimes 
applied directly over the affected region. 

In making mustard paste, the addition of the white of 
an egg modifies the local irritant action, making it more 
easily borne by the skin, and less liable to injure its 
structure, while it does not interfere with the physiologi- 
cal effect. The paste should be mixed only with tepid 
water, as hot water dissipates the volatile oil, vinegar 
destroys it, and alcohol prevents its formation. In- 
ternally, mustard in small amount, as taken with food, 
Stimulates the appetite and gastric circulation. In 
large doses it is a rapidly acting stimulant emetic, 
leaving little or no depression. 

The action of mustard externally must always be 
specially watched with comatose patients, as injury to 
the skin does not show at first in a state of sluggish 
circulation, and may become serious before it is noticed. 
Emetic dose, § ss., in warm water. 

Nat. Ord. Polygalaceee. 

Senega (Snake-Root). 

The dried root of polygala senega, of the Middle and 
Southern United States. The active principle is saponin, 



THE VEGETABLE KINGDOM. 12$ 

a glucoside, allied to digitonin, one of the active princi- 
ples of digitalis. 

Senega acts upon the bronchial mucous membrane as 
a stimulant expectorant and also stimulates the skin 
and kidneys, increasing the amount of urine and its solid 
constituents. It is not readily absorbed by the stomach. 
Small doses impair digestion, and large ones irritate the 
stomach and intestines, causing nausea, vomiting, and 
diarrhoea. 

Preparations of Senega. 

Extractum Senegae. 

Dose, gr. v.-x. 
Abstractum Senegae Fl. 

Dose, Til x.-xv. 
Syrupus Senegae. 

Dose, 3 i. 

Nat. Ord. Sapindacece. 

Guarana (Brazilian Cocoa). 

The seeds of paullinia sorbilis. They contain an 
active principle, guaranine, which is similar to caffeine. 

Abstractum Guaranae Fl. 

Dose, 3 i.-ii. 

Nat. Ord. Erythroxylaceai. 
Erythroxylon (Coca). 

The coca tree is cultivated in South America. The 
dried leaves have a bitter, aromatic taste, and an odor 
like tea. They are extensively used by the natives, who 
chew them as a stimulant during hard labor, scarcity of 
food, etc. They contain an alkaloid, cocaine, the 
active principle. 

Coca in small doses is stimulant, tonic, and restora- 
tive. It strengthens the heart and respirations, raises 
arterial tension, increases the supply of blood to the 
brain, producing wakefulness, and lessens the sensations 



126 MATERIA MEDIC A FOR NURSES. 

of hunger and fatigue. It has diuretic action, and de- 
creases the amount of urea by checking tissue waste. 
Under the influence of coca, or cocaine, the skin is 
flushed, the circulation excited, and a sense of heat and 
perspiration result. 

Cocaine in solution has decided action as a local 
anaesthetic. If applied to a mucous surface, as the 
tongue or conjunctiva, or if given hypodermically, it 
quickly paralyzes the sensory nerves and contracts the 
small vessels, producing a state of local anaemia and 
anaesthesia, which lasts for fifteen minutes, or longer, in 
proportion to the strength of the application. It is often 
used in this way for minor surgical operations (amputa- 
tion of a finger ; opening of an abscess, etc.). Applied 
to the eye it causes dilatation of the pupil, which begins in 
a few minutes, reaches its height in about an hour, and 
returns to the normal state in twenty-four hours. 

Symptoms of Poisoning. 

Overdoses weaken the heart and the pulse becomes 
small, rapid, and intermittent. There is a feeling of 
tightness about the chest ; the respirations are slow and 
shallow, and the skin cold and clammy. There are 
sometimes hallucinations and delirium. Poisonous doses 
paralyze the sensory nerves and the respiratory centre. 
This has- been shown by experiments on animals, no 
fatal cases in man being known. 

Five grains taken by mouth have caused alarming 
symptoms : loss of sight, nausea, incoherent speech, 
cyanosis, rapid intermittent pulse, and a feeling of suffo- 
cation. In treating severe depression from the use of 
cocaine, alcohol, opium, and nitrite of amyl are used as 
antagonists. 

The habit of constantly taking large doses of cocaine 
is readily formed, and produces emaciation, insomnia, 
and disordered digestion. If carried to excess the intel- 
lect is weakened, even to insanity. The victim has an 
uncertain gait, an apathetic air, eyes sunken and sur- 
rounded with a deep purple ring, trembling lips, teeth 
crusted with a greenish deposit, a peculiar blackness 



THE VEGETABLE KINGDOM. \2J 

around the corners of the mouth, and excessive fetor of 
the breath. Ascites sometimes appears, and death may 
result from a general wasting of the vital powers. 

Preparations of Coca. 

Extractum Erythroxyli FI. 
Fluid Extract of Coca. 

Dose, 3 ss.-ii., moderately diluted. 
Cocainae Hydrochloras. 
Hydrochlorate of Cocaine. 

The solution of the hydrochlorate of cocaine is the 
familiar one, and is put up in varying strength, 2 per 
cent., 4 per cent., and 8 per cent., approximately. The 
2-per-cent. solution has gr. x. to § i. ; therefore 3 i. 
equals gr. ij. The 4-per-cent. solution, the most com- 
mon one, contains gr. 2\ in 3 i., gr ii in "HI xxx., gr. 
f in TT[ xv. One grain is represented by TTj, xxiv., and 
the minims and drops are equal. Cocaine is used hypo- 
dermically as a heart stimulant. 

Dose, gr. |-i. 

Nat. Ord. Linacecz. 
Linseed (Flaxseed). 

The -dried ripe seeds of the flax. They contain a fixed 
oil and a quantity of mucilage. The whole seeds are 
used to make a demulcent drink, flaxseed tea ; ground 
into meal, they are used for poultices ; and the oil, mixed 
with equal parts of lime-water, is called Carron oil, and 
is used as a dressing for burns. 
Flaxseed Tea. 

Pour one quart of boiling water over four ounces of 
flaxseed (whole). Let it boil for half an hour, and after- 
wards stand near the fire for fifteen or twenty minutes. 
Strain and sweeten it, and flavor with lemon-juice. 
Flaxseed Poultice. 

A flaxseed poultice must be made over a fire, or alco- 
hol lamp. The water must be boiling actively when 
the meal is added, and must continue to boil until the 



128 MATERIA MEDIC A FOR NURSES. 

poultice is done. Flaxseed bubbles and seethes at a 
point of heat below the boiling point of water, and is 
thus deceptive if it is added to the water in the first 
place. It must be sprinkled in with the left hand and 
stirred constantly with the right. If added in handfuls 
the poultice will be lumpy. When it has reached a 
proper consistency, not thick enough to be stiff, nor 
thin enough to run, it must be taken off the fire and 
thoroughly beaten for several minutes. This makes it 
light and spongy. A perfect poultice will leave the 
spoon and vessel clean, and reaches this point by being 
sufficiently boiled. 

Flaxseed poultices are sedative. They relieve pain 
and relax spasm. In the early stages of an inflamma- 
tion they draw the blood to the surface and relieve con- 
gestion. Resolution may thus be brought about and the 
formation of pus avoided. 

If suppuration has begun, the action of poultices 
favors the process. It is, therefore, not considered well 
to use them in the later stages of an acute inflammation, 
as is often seen done in the home treatment of abscesses, 
etc. Such cases should be brought to a physician for 
proper treatment, and this is the more important if the 
inflammation is near a joint. 

Poultices, if kept up too long, give the tissues a 
flabby, water-soaked appearance ; make granulations 
pale, flabby, and unhealthy ; depress the circulation and 
the vaso-motor system, and may impair seriously the 
vitality of the part. 

Nat. Ord. Malvacecz. 

Gossypium (Cotton-Wool ; Cotton). 

Cotton-wool is too familiar to need description, and 
is introduced here as the first step in making collodion. 

Pyroxylinum (Gun-Cotton). 

Made by treating cotton-wool with sulphuric and nitric 
acids. It is explosive, and is soluble in a mixture of 
ether and alcohol. 



THE VEGETABLE KINGDOM. 1 29 

Collodium (Collodion). 

Made by dissolving pyroxylin in a mixture of stronger 
ether and stronger alcohol. When applied to the skin, 
after evaporation of the ether and alcohol, a colorless, 
transparent, contractile film is deposited, impervious to 
air and moisture. The vapor of collodion is inflammable. 

Collodium Flexile. 
Flexible Collodion. 

Contains Canada turpentine and a small proportion of 
castor oil. The oil renders the film pliable, and prevents 
its contraction. 

Collodium cum Cantharide. 
Vesicating Collodion. 

Collodion containing a solution of cantharides, and 
used as a vesicant. The skin must be washed with the 
same precautions used in applying cantharides, and from 
three to five coats painted on with a brush, letting each dry 
separately. The action of the vesicating collodion is 
hastened by spraying with ether after application. 

Nat. Ord. Byttneriacea. 
Oleum Theobromae (Cacao Butter). 

An oil expressed from the seeds of theobroma cacao, 
the chocolate tree. It has the consistency of tallow, and 
melts at the temperature of the body. It does not become 
rancid, and is used as an unguent and in the prepara- 
tion of suppositories. 

Nat. Ord. Rtttaceoe. 
Buchu. 

The leaves of barosma crenata and other species of 
the same family, from Southern Africa. They contain a 
volatile oil and a bitter extract. 

Buchu is slightly tonic, owing to its bitter principle. 
It is also a stimulating diuretic, and has some 
alterative power. 
Extractum Buchu Fluidum. 

Dose, 3 i., well diluted. 
9 



I30 MATERIA MEDIC A FOR NURSES. 

Oleum Rutas (Oil of Rue). 

Oil of rue is distilled from an herb, ruta graveolens. It 
is a carminative and emmenagogue. 
Dose, "ni iii.-vi. (TTi x.-gtt. xiii.). 

Pilocarpus (Jaborandi). 

The dried leaves of pilocarpus pinnatus, from Brazil. 
They yield, as the active principle, an alkaloid called 
pilocarpine. 

Physiological Actions. 

Jaborandi, if applied to the conjunctiva, causes con- 
traction of the pupil, with disturbances of vision. The 
effect is shown in about ten minutes, and in a hour or 
two after begins to pass off, disappearing entirely within 
twenty-four hours. Pilocarpine, or the preparations of 
jaborandi, enter the blood rapidly, and pass into the tis- 
sues. The most prominent action of the drug is that of a 
prompt and powerful diaphoretic and sialogogue. It 
is also a cardiac and motor depressant. 

When 60 to 90 grains of the infusion of jaborandi are 
given to an adult, after about ten minutes the face and 
neck are flushed, and salivation and perspiration set 
in. These symptoms may appear in five or six minutes 
after a hypodermic injection of the alkaloid. 

Perspiration begins on the face, and extends down- 
ward, lasts from three to five hours, and is profuse in the 
extreme, amounting to J ix.-xv., and becomes alkaline in 
reaction, if it is not so at first. The flow of saliva may 
equal § x.-xxv. It is sometimes the case that with pro- 
fusion of one secretion there will be scantiness of the 
other. The secretions of the eyes and nose are stimu- 
lated. Sometimes nausea and vomiting are caused. The 
pulse is at first stimulated and quickened, but as dia- 
phoresis goes on it becomes slow and weak. The 
respirations are lowered, and apncea may result from 
an increase in the mucus of the bronchial tubes. The 
temperature falls from 1 ° to 4 °, and a depressed condi- 



THE VEGETABLE KINGDOM. 131 

tion results, with pallor, chilliness, and general weakness, 
lasting for several hours. 

The pupils are contracted, and vision impaired. 

Jaborandi, in small doses, is diuretic, and increases 
the elimination of urea. 

The patient undergoing the diaphoretic action of 
jaborandi should be placed between blankets, and the 
depression is to be combated by external heat, which 
also assists the diaphoretic action of the drug. Within 
three to six hours the effects have passed away. 

Children bear relatively larger doses without harm than 
do adults. 

Preparations. 

Extractum Pilocarpi Fl. 

More certain in action, less nauseating and disagree- 
able to take than the infusion of jaborandi, which was 
formerly used. Dose, TT[ xv.-3 i. (Til x. = gtt. xx.). 

Pilocarpine Hydrochloras. 
Hydrochlorate of Pilocarpine. 

A solution for hypodermic use. Dose, gr. ^-J. 

Nat. Ord. Simarubacece. 
Quassia. 

The wood of simaruba excelsa, a tree of Jamaica. 

The active principle, quassin, is an intensely bitter 
neutral substance. 

Quassia is one of the most active of simple bitters 
and Stomachics. It contains no tannin, and is there- 
fore not incompatible with iron. 

An infusion of quassia used as an enema is anthel- 
mintic. 

Preparations. 

Tinctura Quassias. 
Tincture of Quassia. 

Strength, 1 to 9. Dose, Til xx - 3 i. (Tit x. = gtt. xiv.). 



132 MATERIA MEDIC A FOR NURSES. 

Extractum Quassias Fl. 
Fluid Ext. of Quassia. 

Dose, 1U v.-x. Both preparations to be diluted rather 
freely and given before meals. 

Nat. Ord. RhamnacecB. 
Cascara Sagrada. 
Sacred Bark; California Buckthorn. 

The bark of rhamnus purshiana. 

Cascara in small doses is tonic and stomachic ; in 
large doses, laxative or cathartic, with active and 
certain effect. It sometimes causes griping pain. 

Ext. Cascara Sagradae Fl. 
Fluid Ext. of Cascara. 

Maybe given at night, or one or two hours after meals. 
Dose, at night, 3 ss. ; after meals, TU x.-xv., well diluted. 

Nat. Ord. Amyridacecz. 
Myrrha (Myrrh). 

A gum resin which exudes from the stem of a species 
of balsam. Tincture of myrrh, like other oleo-resins, is 
mildly stimulant and disinfectant, and is useful in 
making mouth washes for the sick. 

It has some action as a Stomachic, and in certain 
cases aids the action of purgatives. It is also a uterine 
stimulant and emmenagogue. 

Nat. Ord. Leguminosce. 
Tragacantha (Tragacanth). 

A gum resin which exudes from the stem of astragalus 
gummifera ; used to make a demulcent drink. 

Scoparius (Broom-Tops). 

The fresh and dried tops of cystisus scoparius, of 
Europe and the United States. They contain two active 



THE VEGETABLE KINGDOM. 133 

principles, scoparine and sparteine. Scoparius is an 
excellent diuretic. 

Dose of the infusion, f i, 

Sparteinae Sulphas. 
Sulphate of Sparteine. 

A liquid alkaloid obtained from scoparius. It is 
colorless, with bitter taste, and with sulphuric acid 
forms a crystalline salt, which is soluble in water. 

Physiological Actions. 

Sparteine is slightly hypnotic, but is more important 
as a cardiac stimulant, increasing the force and regu- 
larity of the pulse. It acts very quickly, its influence 
over a weak, failing heart being shown within half an hour 
to one hour, but it does not last long, wearing off in four 
or five hours. 

It is not considered equal to digitalis, but it is often 
given with it and with other more enduring but slowly 
acting stimulants. It is not accumulative, and does not 
disturb digestion nor impair the appetite. 

It has not the diuretic action of scoparius. In larger 
doses it is a depressant to the brain and spinal cord, and 
causes death by paralysis of the respiratory centre. Doses 
of four to six grains produce vertigo, headache, palpi- 
tations, and a feeling of formication in the extremities ; 
and larger doses have caused loss of power in the legs, 
sensations of heat, with flushed face and severe pain 
about the heart, the symptoms beginning in about twenty 
minutes and reaching their climax in four or five hours. 

Dose, gr. ^V""- 

Glycyrrhiza (Licorice-Root). 

The root of glycyrrhiza glabra, cultivated in England. 

Licorice is demulcent. It contains grape-sugar, 
starch, resin, and a glucoside named glycyrrhizin. 
Pulvis Glycyrrhizae Compositus. 
Compound Licorice Powder. 

A laxative preparation containing senna, licorice- 
root, fennel, sugar, and sulphur. Its action resembles 



134 MATERIA MEDIC A FOR NURSES. 

that of castor oil. It is not a hydragogue cathartic, and 
given in moderate doses causes no griping, and acts 
gently — in the morning if given at night ; in from three to 
six hours if given early on an empty stomach. Many pa- 
tients find it nauseous ; it is therefore best to make the 
dose small as possible by diluting it only a little and 
giving afterwards a larger quantity of water. 
Dose, 3 i.-iv. 

Balsamum Peruvianum (Balsam of Peru). 

A balsam exuded from the trunk of myroxylon pereirae. 
It is a reddish-brown or nearly black liquid, thick and 
syrupy, and insoluble in water. It contains benzoic 
acid, a number of resinous principles, a volatile oil, and 
other constituents. 

It is a vascular stimulant and nerve sedative, 
antiseptic, and disinfectant, and is used externally as 
an application to granulating surfaces. It is not used 
internally, though it has mild action as a carminative 
and as a stimulant and disinfectant expectorant. 

Balsamum Tolutanum (Balsam of Tolu). 

Balsam of tolu is obtained from the trunk of myroxy- 
lon toluifera. It is a reddish-yellow, soft, and sticky 
substance of fragrant odor, soluble in alcohol. It yields 
benzoic and cinnamic acids, various resins, etc. Its prop- 
erties are the same as those of balsam of Peru ; but it is 
only used internally as an ingredient of cough mixtures. 

Physostigma (Calabar Bean). 

The dried seeds of physostigma venenosum, an African 
plant. They contain two alkaloids : calabarine, the less 
important one ; and physostigmine, or eserine, the active 
principle. 

Physiological Actions. • 

Applied to the eye, physostigmine is absorbed by the 
conjunctiva, and causes contraction of the pupil, with 
slight twitching of the eyelids, dimness of vision, and 
pain over the eyes. 



THE VEGETABLE KINGDOM. 1 35 

Calabar bean acts as a depressant on the medulla and 
spinal cord, but does not affect the cerebrum, the mind 
remaining clear in cases of poisoning. In moderate doses 
it sometimes produces nausea, colic, and increased peri- 
staltic motion, resulting in diarrhoea. 

The heart is first stimulated, and then weakened, and 
the same contraction of the pupil takes place after its 
internal use. 

Symptoms of Poisoning. 

The first symptoms of poisoning are : giddiness, weak 
pulse, muscular feebleness, vomiting, and free purging. 
The respirations become slow and irregular, and death 
results from paralysis of the respiratory centre. 

The poison is treated by emptying the stomach, apply- 
ing external heat, and using artificial respiration. 
Atropine is a physiological antagonist, and is given in 
doses not larger than gr. ^. 

Recovery has taken place, by means of prompt emesis, 
after a dose of gr. xii. 

Preparations. 

Extractum Physostigmatis. 

Dose, gr. T V4> 
Tinctura Physostigmatis. 

Dose, TTJ, xx.-xl. (TH, x. = gtt. xiv.). 
Physostigmine. 

Dose, gr. T V 

Senna. 

The dried leaflets of two varieties of cassia, from 
Africa and Arabia. The active principle is cathartic 
acid, and there are other unimportant principles. 

Senna is a simple cathartic, and acts as a stimulant to 
the muscular coat of the intestines, producing local reflex 
action, active peristalsis, and free evacuations within four 
or five hours. It acts especially on the colon, and does 
not cause constipation after its action is over. Griping 



I36 MATERIA MEDIC A FOR NURSES. 

pains are caused by full doses, but it is usually given in 
combination for the purpose of avoiding this. 

Senna is excreted by the kidneys and the mammary 
glands. Nursing infants in this way feel its action as a 
laxative. 

Preparations. 

Extractum Sennae Fl. 

Dose, 3 ii.- ? ss. 
Confectio Sennae. 

This preparation tends to disorder the digestion. 
Dose, 3 i-ii. 

Infusum Sennae Compositus. 
Black Draught. 

Contains manna and sulphate of magnesium, and is an 
active hydragogue purgative. Dose, § iv. 

Syrupus Sennae. 
Dose, 3 i.-iv. 

Nat. Ord. Rosacea. 
Amygdala Amara (Bitter Almond). 

The ripe seeds of prunus amygdalus, the bitter almond 
tree. The important principle of the bitter almond is 
a volatile oil, which contains from 4 to 8 per cent, of 
hydrocyanic acid, and is highly poisonous. 

The artificial oil of bitter almonds, nitro-benzene, or 
nitro-benzol, is poisonous, and has caused death. 

Nat. Ord. Cuburbitacea. 
Colocynthis (Colocynth). 

The dried, peeled, and seeded fruit of citrullus colo- 
cynthis, or bitter cucumber, from Eastern countries. 
The active principle is colocynthin. 

Colocynth is a powerful hydragogue and drastic 
cathartic, irritant, and quickly acting, causing large 
watery evacuations, with griping pains and general de- 
pression. Besides acting as a stimulant to the muscular 



THE VEGETABLE KINGDOM. ^ 137 

coat of the intestines, it also acts on the intestinal glands 
and on the liver. To avoid the severity of its effects, it 
is always given in combination, and is not suitable as a 
habitual purgative, being irritant to the stomach as well 
as to the bowels. 

Gastro-enteritis is caused by colocynth in poisonous 
quantity, and death has resulted in twenty-four hours 
from a dose of 3 i.- 3 iii- of the powder. 

Preparations. 

Extractum Colocynthidis. 

Purgative dose, gr. iii.-v. 
Extractum Colocynthidis Compositus. 
Compound Ext. of Colocynth. 

Contains extract of colocynth, aloes, scammony, and 
cardamom. 

Laxative dose, gr. i.-iii. 

Purgative dose, gr. v.-xx. 

Elaterinum (Elaterium ; Squirting Cucumber). 

Elaterium is a sediment obtained from the juice of 
ecballium elaterium, from Greece, and cultivated in 
England. It contains a neutral active principle, elaterin, 
which is the officinal preparation, elaterium being of 
variable strength. 

The most active hydragogue cathartic known, pro- 
ducing excessive watery evacuations in a very short time. 
If the dose is not too large there is little or no pain or 
irritation, although in excess it is a gastro-intestinal 
irritant. It is also irritant if applied to the skin. The 
purgative action of elaterium is exhausting, and the con- 
dition of the patient must be watched. Catharsis is also 
produced when it is injected hypodermically, but it can- 
not be safely used in this way, as it is very irritant to 
the tissues, and has been followed by tetanus. 

Preparations. 

Elaterium. 
Dose, gr. \. 



I38 MATERIA ME DIC A FOR NURSES. 

Elaterin. 

Dose, gr. j\. 
Trituratio Elaterini. 

Strength, 1 to 10. Dose, gr. \. 

Nat. Ord. Umbelliferce. 
Conium (Spotted Hemlock). 

The fruit and flowers of conium maculatum, belonging 
to Europe and naturalized in the United States. They 
have an odor resembling that of mice. The active 
principle is conine, a very volatile alkaloid, freely soluble 
in alcohol and ether, and slightly so in water. On ex- 
posure to the air it decomposes, and this change is 
assisted by heal. 

Physiological Actions. 

Conium is a motor depressant, paralyzing the motor 
nerves from below upward. It affects the respiratory 
centre, paralyzing it. The cardiac and vascular centres 
are not specially influenced. The brain is not affected 
but remains clear. 

When conium is taken in doses just large enough to 
make an impression, the first effect noticed is muscular 
weakness in the legs. The feet feel weighed down, or 
as if made of lead ; the knees weak and unable to bear 
the body, giving an intense desire to lie down, and the 
patient cannot walk, but staggers and falls. 

The eyelids are affected and drop over the eyes ; the 
vision is disordered, and there is frontal headache, with 
a feeling of heat, or of weight and pressure, in the head. 

Conium is used as an antispasmodic ; also some- 
times as an analgesic, and as a calmative in conditions 
of hysterical and maniacal excitement. It is well borne 
by children. 

Symptoms of Poisoning. 

In serious poisoning the symptoms mentioned above 
\re all intensified. The pupils dilate ; the pulse, at first 



THE VEGETABLE KINGDOM. 1 39 

diminished, afterwards becomes more rapid. The res- 
piratory centre is paralyzed, and death results from 
asphyxia in a very short time — in one case in a few 
moments. There are but few recorded cases of fatal 
poisoning. Hemlock was the state poison of Athens in 
the time of Socrates, and the means of his death. 

Treatment of Poisoning. 

No physiological antidote to conium is known. The 
stomach must be emptied and tannic acid given, stim- 
ulants employed and external heat applied, and artificial 
respiration practised as long as there is any heart action. 

Preparations. 

Abstractum Conii. 

Dose, gr. i.-ii. 
Extractum Conii Alcoholicum. 

Dose, gr. i. 
Tinctura Conii. 

Strength, i to 6.6. Dose, 3 ss.-i. 
Extractum Conii Fluidum. 

The best preparation. Dose, "ni i.-ii. (TT[ x. = gtt.-xx.). 
Conine. 

Dose, m T y-iii. ; or gr. eViV 

Asafoetida. 

A gum resin obtained by incising the root of different 
species of ferula, of Afghanistan. It contains a volatile 
oil, a resin, and gum. The oil is complex, but consists 
largely of the essential oil of garlic, to which it owes its 
unpleasant odor. The resin also yields sulphur. 

Physiological Actions. 

Asafoetida has, in the stomach and alimentary canal, 
the stimulant and disinfectant action belonging to 
volatile oils and resins ; but while most others are pleas- 
ant to the taste, it is exceedingly nauseous and disagree- 



I-4-O ' MATERIA MEDIC A FOR NURSES. 

able. The mental influence of this nauseous impression, 
combined with its physiological action, renders asafcetida 
a nerve stimulant, antispasmodic, and calmative 
in hysterical conditions. 

It is a carminative, and in enemata dispels gas, stops 
convulsions, and relieves constipation. It has some 
slight action as a stimulant and disinfectant ex- 
pectorant. The volatile oil is excreted by the urine, 
perspiration, and breath. 

Preparations. 

Pilulae Asafoetidae. 

Gr. iii. in each. Dose, ii.-iv., pills. 

j Mistura Asafoetidae. 
( Milk of Asafoetida. 

Dose, § ss.-i. For use in enemata, § i.-iii. 

Tinctura Asafoetidae. 

Stength, I ii.-Oj. Dose, f ss.-i. 

Ammoniacum (Ammoniac). 

A gum resin exuded from the stem of dorema ammonia- 
cum, of Persia. 

The physiological actions are unimportant. It is a local 
irritant and in large doses produces vomiting and pur- 
ging. It is a disinfectant expectorant, being excreted 
by the bronchial mucous membrane, and is used ex- 
ternally as a mild counter-irritant and local stimulant, 
to promote circulation in the skin and aid absorption. 

Preparations. 

Mistura Ammoniaci. 
Dose, 3 ss. 

Emplastrum Ammoniaci. 
Ammoniac Plaster. 



THE VEGETABLE KINGDOM. 141 

Nat. Ord. Rubiaceaz. 
Cinchona. 

The trees belonging to the genus cinchona are found 
native in South America, on mountains at a height of 
5,000 to 10,000 feet, and they are being successfully cul- 
tivated in other countries. The bark is the part used in 
medicine. 

There are many varieties of the tree, the most import- 
tant being cinchona succirubra, from which " red bark * 
is obtained, and cinchona calisaya, from which comes 
the " yellow " or " calisaya bark." A bark called " pale 
bark " is obtained from two minor varieties, and, finally, 
under the general name " cinchona " or " Peruvian 
bark " are included all other varieties of the tree yield- 
ing two or three per cent, of the alkaloids which contain 
crystallizable salts. 

Cinchona contains four principal alkaloids : quinine, 
the most important ; quinidine, the strongest anti-peri- 
odic, but existing in very small quantities ; cinchonine, 
about half the strength of quinine ; and cinchonidine, 
a little stronger than cinchonine. 

The yellow bark contains most quinine, the pale bark 
most cinchonine, and the red bark about equal quantities 
of each. Beside these important alkaloids and a number 
of unimportant ones, cinchona bark contains tannic and 
other acids, a resinous substance, coloring matter, etc. 

Physiological Actions. 

The preparations of cinchona bark as a whole are used 
as bitter stomachics and tonics. 

They are too bulky to be used as antipyretics or anti- 
periodics if quinine can be obtained. They have some 
astringent action, due to the tannin they contain. 

Preparations. 

Infusum Cinchonae. 
Infusion of Cinchona. 

Strength, 1 to 16.6. Dose, | i. 



142 MATERIA MEDIC A FOR NURSES. 

Tinctura Cinchonas. 

Strength, i to 5. Dose, 3 i. — ii- 

Tinctura Cinchonae Compositus. 
Huxham's Tincture. 

Contains cinchona, glycerine, bitter orange-peel, ser- 
pentaria, and alcohol. Dose, 3 L— \ ss. 

Extractum Cinchonae Fluidum. 

Dose, TU v.-xv. (iU x. = gtt. xx.). 

The preparations of cinchona are given half an hour 
before meals. 

Quinina (Quinine). 

Quinine is prepared from the powdered cinchona bark 
by various chemical processes, in the course of which an 
alkali and sulphuric acid are both used. 

Alkalies, and their carbonates, and tannic acid are in- 
compatible with quinine and the other alkaloids of cin- 
chona. The alkalies precipitate them from solution, and 
tannin forms with them insoluble compounds. 

One grain of dilute sulphuric acid will dissolve one 
grain of quinine. 

Physiological Actions. 

Quinine arrests some processes of fermentation and 
decomposition, and might, except for its cost, be used as 
a local antiseptic and disinfectant. It is readily 
absorbed, and is frequently given by rectum ; it is also 
used hypodermically, though it is very irritating and 
liable to produce abscesses. 

In small doses it is a powerful bitter stomachic and 
general tonic, stimulating digestion and increasing appe- 
tite. In large doses it may irritate and cause nausea and 
vomiting, or even gastritis. 

Quinine may be found in the blood a few minutes after 
being taken, and retards oxygenation. It enters the tis- 
sues quickly and is excreted slowly, several days being 
required. The maximum effect of a large dose is reached 
in about five hours. Small doses quicken the heart and 



THE VEGETABLE KINGDOM. 1 43 

raise the blood pressure. Large ones depress the heart, 
diminish the force and frequency of its contractions, and 
lower blood pressure. The respirations are also depressed 
by large doses. 

Quinine acts strikingly on the nerve centres. Small 
doses stimulate the brain and increase the activity of the 
mind, while slight overdoses produce headache and 
ringing in the ears, with deafness, more or less pro- 
nounced. Full doses intensify these symptoms, and 
cause severe pain, constriction, and fulness in the head, 
confusion of the mental faculties, intense nervous irrita- 
bility, giddiness, disorders of vision, and general prostra- 
tion from depression of the spinal cord and circulation. 

The pre-eminent power of quinine is shown in its 
control over malarial poisoning as an antipyretic, anti- 
periodic, and prophylactic. (A medicine to be pro- 
phylactic must belong either to the class of restoratives, 
supplying a deficiency of some natural and essential con- 
dition of the body, or to the class of germicides, prevent- 
ing disease by destroying the injurious agent.) 

Quinine has some power as an oxytocic, contracting 
the uterus. The question " Does it, or does it not, pro- 
duce abortion?" is still debated, and has not yet been 
decided in the affirmative. 

Incidental Effects. 

Eruptions of the skin are sometimes observed after the 
use of quinine, even in small doses. A rash resembling 
that of scarlet-fever may appear, followed by severe itch- 
ing and smarting, and desquamating finally. More rarely 
the eruption resembles urticaria, popularly known as 
" hives " or " nettle-rash." Occasionally irritation of the 
urinary organs is caused, with pain, congestion of the 
kidneys, or even hemorrhage. This is more liable to 
occur with old people. Idiosyncrasy exists in a marked 
degree with some persons, in regard to quinine, forbid- 
ding the use of even the smallest doses. 

If much prostration follows the administration of qui- 
nine, strong black coffee with brandy is the best antidote. 
In giving quinine, ringing in the ears and deafness are 
the first symptoms to be looked for. 



144 MATERIA MEDIC A FOR NURSES. 

Quininse Sulphas. 
Sulphate of Quinine. 

Usually given in pills or capsules on account of the 
bitter taste. Sometimes, when rapid action is desired, it 
is given in solution. The taste is very persistent and is 
better removed by a piece of dry bread, or an olive, than 
any thing else. The powdered sulphate maybe given in 
sherry wine. 

Quinine pills should not be more than ten days old, as 
then they become so dry and hard as to be useless, pass- 
ing through the alimentary canal without dissolving. 
Quinine should be given on an empty stomach, or after 
the process of digestion is partly over. If a patient is 
on milk diet quinine should not be given in solution near 
the milk, as it is very liable to cause vomiting. Other- 
wise there is no incompatibility between quinine and milk. 

Tonic dose, gr. i.-v. 

Antipyretic or antiperiodic dose, gr. x.-xxx. 
Quinia Bimuriatica Carbamidata. 
Quinine and Urea. 

A new compound of muriate of quinine, muriatic acid, 
and urea, intended for hypodermic use. It is usually 
prepared in strength of gr. iii. to ^ x. It is very satis- 
factory, as it does not irritate or produce abcesses. It is 
best given deeply in muscular tissue, and special pains 
taken to keep the needle clean. 

Warburg's Tincture. 

A preparation with an exceedingly long formula, con- 
taining over a dozen drugs of vegetable origin, with a 
certain proportion of quinine, the most active ingredient 
(between 9 and 10 grains to the ounce). It is used as a 
diaphoretic, and is best given at night. 
Dose, 1 ss. 

Ipecacuanha. 
Ipecac. 

The dried root of cephaelis ipecacuanha, of Brazil. 
Ipecac contains from J to 1 per cent, of the active prin- 
ciple, emetine, and also a glucoside, starch, gum, etc. 



THE VEGETABLE KINGDOM. 145 

Physiological Actions. 

Externally, powdered ipecac irritates the skin, causing 
a pustular eruption. Mucous membranes are similarly 
irritated, and an increased bronchial and nasal secretion, 
sneezing, etc., follows its local application. Taken in- 
ternally, it tends to soften and liquefy hard and tenacious 
mucous secretions. 

In the stomach ipecac in very small doses (gr. J) is a 
gastric stimulant, increasing local circulation and 
secretion. In these minute doses it checks vomiting. 

In large doses it is a familiar emetic, safe and prompt, 
and non-depressing. Its action is partly direct and 
partly indirect, the act of vomiting being promoted both 
by local action on the stomach walls, and by stimulation 
through the influence of emetine of the vomiting centre 
in the medulla. 

The emesis caused by ipecac takes place in from 
twenty to thirty minutes after administration, and occurs 
usually only once. There is but very little nausea before 
or with the act of vomiting, nor is it followed by ex- 
haustion. It is accompanied by a decided increase in the 
secretions of the gastric and bronchial mucous mem- 
branes, and the sputum thus being made more fluid, with 
the expulsive act there is a general clearing out of the 
bronchial tubes, the trachea, and the nasal cavities. 

Ipecac, as an emetic, is between sulphate of zinc and 
tartar emetic, not being as prompt as the first, nor as 
nauseating as the second. It is not powerful enough to 
give alone in cases of poisoning, but is then used as 
an aid to other emetics. It is very suitable for children, 
and they bear it in relatively large doses. 

Ipecac is a sedative expectorant, a direct chola- 
gogue, increasing the flow of bile, and a diaphoretic 

Preparations. 

Pulvis Ipecacuanha. 
Powdered Ipecac. 

Dose, gr. xx. 
10 



I46 MATERIA ME DIC A FOR NURSES, 

Syrupus Ipecacuanhae. 

Strength 5 parts fluid ext. to 100. Dose for infant, 
3 .ss-ii. 

Vinum Ipecacuanhae. 

Strength 1 part fluid ext. to 7 white wine. Dose, 3 ss.-ii. 

Extractum Ipecacuanhae Fluidum. 

Emetic dose for adult, TTX, xxx. (TT[ x. gtt. xx.). 

Emetine. 

Dose, gr. \-\. 

All these preparations are best given with plenty of 
warm water, in cases of poisoning ; with croupy children, 
however, swallowing being difficult, it is best not to di- 
lute the dose, or but very little. 

Catechu. 

An extract from the wood of acacia catechu, from the 
East Indies. It contains kino-tannic and catechinic 
acids, and is a strong astringent. 

Tinctura Catechu Compositus. 

Dose, 3 i.-iii. 

Nat. Ord. Rubiacece. 
Coffea Arabica (Coffee Plant). 

The seeds of the coffee plant, grown in Arabia, yield 
the alkaloid caffeine (which is also obtained from plants 
belonging to different families, viz., paullinia sorbilis, 
guarana). The coffee seeds also contain sugar, tannic 
acid, caffeic acid, a volatile oil, etc. 

The qualities of coffee as a beverage are too familiar 
to need mention. In moderation, and when well made, 
it aids digestion and has laxative effect. In excess, or 
when improperly made and allowed to boil, it causes 
dyspepsia by the astringent action of its tannic acid. 



THE VEGETABLE KINGDOM. \\J 

Caffeine. 

Caffeine is distinguished by containing more nitrogen 
than almost any other vegetable principle. It is absorbed 
unchanged into the circulation, and is a Stimulant to 
the brain and heart, producing wakefulness, with a clear, 
vigorous state of the intellect, and strengthening the 
contraction of the heart. 

It resembles digitalis in its action as a cardiac stimu- 
lant, but acts more promptly and is more transitory in 
its effects. 

It has no decided cumulative tendency, and does not 
disagree with the stomach. It acts as a diuretic by 
stimulating the cells of the kidneys, as well as by its 
action on the heart and circulation. 

It has been known to cause, after doses of moderate 
size, nervous wakefulness and restlessness, tremulousness, 
frequent pulse, confused thought, and visions passing in 
a constant train. These symptoms have lasted for several 
hours. 

In large "doses it has caused poisonous though never 
fatal symptoms, such as muscular tremor, a burning 
feeling in the throat, palpitations with rapid, violent 
pulse and short, quick respirations ; giddiness, nausea, 
disordered vision, and marked diuresis. 

Dose of caffeine, gr. v.-xx. 

Nat. Ord. Tei-nstromiacecz. 
Camellia Thea (Tea Plant). 

The leaves of the tea plant, grown in China, contain 
theine, the active principle ; tannic acid, and a volatile 
oil. Theine was formerly considered to be identical 
with caffeine, but investigators have recently pronounced 
them to be different. 

Tea is stimulating and refreshing. Used to excess 
it weakens the digestive system and causes constipation, 
depresses the heart and vaso-motor nerves, producing 
neuralgic pains. In cases of poisoning, when tannin is 
needed, it may sometimes be most quickly procured in 



148 MATERIA MEDIC A FOR NURSES. 

the form of strong, rank tea. By boiling it hard and 
squeezing dry the leaves, the tannin is extracted as 
thoroughly as possible, and the tea is given, without 
sugar or milk, in large quantities. 

Nat. Ord. Valerianacea. 
Valeriana (Valerian). 

The dried rhizome and roots of Valeriana officinalis. 
The active principles are a volatile oil and valerianic 
acid. The latter is found in many other plants, in cod- 
liver oil, and may be derived from amylic alcohol. 

Valerian is a carminative, circulatory stimulant, 
and anti-spasmodic. In nervous cases it sometimes 
acts successfully as an hypnotic. Large doses ( 3 ii.-iv.) 
may cause nausea, vomiting, and colic, a quickened 
pulse, and a feeling of formication in hands and feet. 

Preparations. 

Tinctura Valerianae. 

Strength, § ii. to Oj. Dose, 3 i.-iii. 
Extractum Valerianae Fluidum. 

Dose, 3 i. 

Tinctura Valerianae Ammoniata. 
Ammoniated Tincture. 

Strength, ^ ii. to Oj. Dose, 3 i.-iii. 

Nat. Ord. Composite. 
Santonica (Levant Wormseed). 

The dried flower-heads of artemisia contra, of Asia 
Minor. The active principle is santonin, and there is 
also a compound volatile oil resembling camphor in its 
action. 

Santonin is an anthelmintic, acting especially on the 
ascaris lumbricoides, or round worm. In overdoses it 
produces disturbances of vision and of consciousness. 



THE VEGETABLE KINGDOM. 1 49 

Objects appear at first to be blue, then yellow. There 
are tremors, aphasia, and sometimes convulsions. The 
respirations become feeble, and the pulse is reduced. 

It is necessary, in giving it, to watch its action, that 
these symptoms may be avoided. 

It is excreted by the bowels and by the kidneys, and 
discolors the urine, making it saffron or reddish. There 
have been numerous cases of fatal poisoning among 
children from santonin. Alarming symptoms have been 
caused by gr. ii. in a child eight years old, and a dose of 
gr. ii. to a child of five years caused death. 

Dose, gr. J-v. 

Chamomile. 

The dried flowers of anthemis nobilis, of Europe. 
Chamomile belongs to the class of aromatic bitters, 
stomachics, and tonics. 

Infusum Anthemidis. 
Infusion of Chamomile. 

Dose, a wineglassful before meals. 

Taraxacum (Dandelion). 

The root of the dandelion is a simple bitter and 
mild laxative. 

Extractum Taraxaci Fluidum. 
Dose, 3 i. — ii., after meals. 

Arnicse Flores ; Arnicae Radix. 

The arnica montana, or leopard's bane, grows in North- 
ern Europe and Asia and in the Northwestern United 
States. The root and flowers contain two alkaloids and 
the ammonia compound, trimethylamine, which is found 
in cod-liver oil and in ergot, and may also be obtained 
from various decomposing albuminous substances. 

Externally arnica is stimulating and irritant, in- 
creasing the circulation of the skin. It sometimes 
causes excessive redness and eczema, and must be used 
with care. 



I50 MATERIA ME DIC A FOR NURSES. 

The diluted tincture promotes the absorption of blood 
which has effused into the tissues, as after a blow, and 
prevents swelling. 

Internally, in small doses, arnica is slightly stimu- 
lating to the heart, the skin, and kidneys. 

In larger doses it is a cardiac depressant, and in 
doses equal to § i. of the tincture it has caused the pois- 
onous symptoms of gastro-intestinal irritation ; cold dry 
skin ; feeble fluttering pulse, lowered sometimes to 60 ; 
and occasionally vomiting and purging, with final col- 
lapse. It should never be applied to an open wound. 

Preparations. 

Tinctura Arnicae Flores. 
Tincture of Arnica Flowers. 

Strength, 20 per cent. 
Tinctura Arnicae Radix. 
Tincture of Arnica Root. 

Strength, 10 per cent. 

Both preparations used externally must be diluted, 
applied on a piece of flannel to the inflamed part, and 
covered with a bandage. 

Dose, Til v.-xxx. (ttl x. = gtt. xv.). 

Extractum Arnicas Fluidum. 

Dose, TTt v.-xv. 
Emplastrum Arnicae. 
Arnica Plaster. 

Strength, one third of the extract. 

Nat. Ord. Lobeliacece. 
Lobelia (Indian Tobacco). 

The leaves and tops of lobelia inflata, of the United 
States. The active principle is called lobeline. 

Lobelia is a motor-depressant and anti-spas- 
modic. In small doses it stimulates the alimentary 
canal, and in full doses irritates it, causing pain, vomit- 
ing, purging, and general depression. 



THE VEGETABLE KINGDOM. 151 

Large doses cause, in addition, cold sweats, muscular 
tremors, feeble pulse, and stupor, with coma and col- 
lapse. It has frequently caused death, which occurs by 
paralysis of the respiratory centre. It is very seldom 
used, on account of its very depressing action. 

The treatment of poisoning consists in washing out 
the stomach with a warm solution of tannic acid (or 
warm, strong tea), the application of external heat, 
and stimulation by mustard, friction, etc. ; and the use 
of alcoholic stimulants, ammonia, and opium. 

Preparations. 

Tinctura Lobeliae. 

Strength, 20 per cent. Dose, tt[ x.-xx. (fit x. = gtt. x.). 
Extractum Lobeliae Fluidum. 

Dose, in, i-v. (HI i. = gtt. i.). 

Nat. Ord. Styracacece. 
Benzoinum (Benzoin). 

The thickened juice of styrax benzoin, a tree of Peru. 
It is soluble in alcohol ; not readily soluble in water. 
Benzoin is a balsamic resin, containing from 12 to 
15 per cent, of benzoic acid. It is antiseptic and disin- 
fectant, and is said to have more power than salicylic 
acid to destroy bacteria and prevent putrefaction. 

Applied to the skin, it has a stimulating and heal- 
ing action. Inhaled, or applied in solid form to the 
nose, it irritates the nasal and bronchial mucous mem- 
branes, but in proper solution acts on them only as 
a gentle stimulant. Taken internally it is diaphoretic, 
increases the urine and makes it more acid, and raises 
the pulse rate. It is excreted by the kidneys, partly as 
hippuric acid, and partly unchanged. 

Preparations. 

Acidum Benzoicum. 
Benzoic Acid. 

Dose, gr. x.-xxx. 



152 MATERIA MEDIC A FOR NURSES. 

Tinctura Benzoini. 

Strength, 20 per cent. Dose, 3 ss.-i. 
Tinctura Benzoini Composita. 
Friar's Balsam. 

For external use ; it contains benzoin, aloes, styrax, 
balsam of tolu, and alcohol. 
Ammonii 



Lithii V Benzoas. 

Sodii 

Dose, gr. v.-xxx. 

Nat. Ord. Olcaceoe. 

Oleum Olivae (Olive Oil). 

The oil expressed from the fruit of olea europaea. 
Olive oil is composed of a fluid oil, olein ; a solid oil, 
palmitin ; with oleic and palmitic acids. 

Used externally by inunction, it is absorbed by the 
lymphatics, and has some nutritive value. 

As a mechanical application it is used both externally 
and internally in the treatment of burns and corrosive 
poisons. It acts as a laxative, and is used for this pur- 
pose in enemata, tending to soften the fsecal mass and 
assist in its expulsion. Oils in general are changed into 
carbonic acid and water in the system, and so excreted, 
but an excess will appear unchanged in the urine. 

Nat. Ord. Loganiacecp.. 
Spigelia (Pink-Root). 

Spigelia is an anthelmintic and purgative, and acts on 
the round worm. 
Extractum Spigelian Fluidum. 

Dose, Til x- 3 ii. 

Gelsemium (Yellow Jessamine.) 

The root of gelsemium sempervirens, of the Southern 
United States. The alkaloid gelsemium and gelseminic 
acid are the important constituents. 



THE VEGETABLE KINGDOM. I 53 

Physiological Actions. 

Gelsemium is a motor depressant and anti- 
spasmodic, acting by direct influence on the spinal 
cord. In medicinal doses it is sedative and dia- 
phoretic. 

The smallest active quantity (TTJ, v.-xv.) causes a 
languid feeling, with slight reduction of the strength and 
frequency of the pulse. If the amount be increased, 
pain over the eyes, some disturbance of vision, and diz- 
ziness result, with increased perspiration. It has a 
peculiar nervous effect on some people, making them cry 
without knowing why. 

Symptoms of Poisoning. 

Poisonous doses ( 3 i. of the fluid extract) produce, in 
addition to these symptoms, great muscular weakness, 
affecting especially the flexors of the arms. 

The gait also is affected, and becomes staggering. The 
jaw drops, and articulation fails. There is marked 
effect on the sight : double vision, partial or complete 
blindness may develop ; sometimes a squint is produced; 
the eyelid droops ; the pupil dilates. 

There is profuse perspiration, cold surface and sub- 
normal temperature, and a condition of general anaesthe- 
sia. The pulse is thready and feeble, and death finally 
results from paralysis of the respiratory muscles. Con- 
sciousness remains until carbonic-acid narcosis begins as 
the result of asphyxia. 

Gelsemium is rapidly diffused, and the effects appear 
within half an hour, and, after medicinal doses, disap- 
pear within two or three hours. 

Death, when it occurs, may do so in a few hours, and 
has been known to result from taking one sixth of a 
grain. 

Treatment of Poisoning. 

Poisonous symptoms are treated by emetics, alcoholic 
stimulants, external heat, electricity, and artificial respi- 
ration, if necessary. 



1 54 MA TERIA MEDICA FOR NURSES. 

Preparations. 

Extractum Gelsemii Fluidum. 

Dose, TU v. ("fll x. = gtt. xxv.). 
Tinctura Gelsemii. 

Strength i to 6.6. Dose, 1U x.-xxx. ( TTL x. = gtt. xx.). 

Nux Vomica (Poison Nut ; Quaker Buttons). 

The seeds of strychnos nux vomica, an East Indian 
tree. The active principle is the alkaloid, strychnine, an 
important poison. Two other important principles are 
brucine and igasuric acid. Brucine is of half the strength 
of strychnine. 

Physiological Actions. 

Nux vomica in medicinal doses is tonic, with the 
qualities of bitter stomachics ; it increases appetite, 
aids digestion, and promotes peristalsis. It also stimu- 
lates respiration, the heart, and vaso-motor centres. 
These actions are largely due to the presence and in- 
fluence of strychnine. Strychnine enters the system 
rapidly, especially the nervous tissues, on which its pre- 
eminent action, that of a motor excitant, is shown. It 
is excreted very slowly, not disappearing from the 
tissues for several days, and therefore accumulates in the 
system when given in continuous doses, even small ones. 

The power of strychnine in regard to the nervous sys- 
tem is exerted on the motor centres of the spinal cord 
and all the important nerve centres in the medulla. 

The first constitutional symptoms are a feeling of 
restlessness, with slight trembling of the extremities. 
After a full dose (gr. T V), there are noticeable muscular 
twitching and jerking of the limbs, slight stiffness of the 
jaw, a tense feeling about the head, stricture of the 
throat and chest, shuddering, and a feeling of anxiety. 

Symptoms of Poisoning. 

After poisonous doses (gr. \ for an adult) violent 
symptoms come on very suddenly, probably within 



THE VEGETABLE KINGDOM. 155 

fifteen minutes, with tonic convulsions resembling the 
spasm of tetanus. The legs are rigid, extended, and the 
feet everted, or the body may be bent backward until the 
head and heels meet (opisthotonos). The arms are bent, 
and hands clinched ; the eyes open and staring. The 
corners of the mouth are drawn up by the muscles in a 
mechanical grin, the " risus sardonicus," which gives a 
ghastly unmeaning expression, and the face — at first 
pale — presently becomes livid from asphyxia. 

Between the paroxysms there is a period of relaxation 
and quiet, but the slightest sound, or touch, or breath of 
air brings on the spasms again instantly by reflex action, 
owing to the condition of intense irritability. 

In cases which terminate fatally the spasms succeed 
each other quickly, and death takes place in two or three 
hours from paralysis of the respiratory muscles. The 
mind usually remains clear up to the last. Sometimes 
asphyxia produces insensibility just before death. 

Strychnine convulsions resemble tetanic and hysterical 
convulsions in some particulars. The special points of 
difference are as follows : 

Strychnine. 

The convulsions begin with a restless, excited state ; 
the special senses are sharpened. Muscular symptoms 
come on very rapidly, either beginning in the extremities 
or appearing simultaneously over the body. The jaw is 
the last part affected and the first relaxed. The eyes are 
open, and the muscles are relaxed between the con- 
vulsions. 

Tetanus. 

The symptoms come on gradually, with pain and stiff- 
ness of the back of the neck and occasional slight mus- 
cular twitchings. The jaw is the first part affected, and 
is rigid (trismus, or lock-jaw). There is a permanent 
state of general muscular rigidity. 

Hysteria. 

Begins with weakness and blindness. The muscular 
symptoms begin with stiffness of the neck. The extrem- 



156 MATERIA MEDIC A FOR NURSES. 

ities are affected last. The jaw is set before a convul- 
sion and remains fixed between them. The eyes are 
closed 

Treatment of Poisoning. 

In treating strychnine poisoning, tannic acid or a 
soluble iodine salt is given as an antidote, followed 
quickly by emetics, as the compounds thus formed are 
not permanent. The bladder must be emptied to prevent 
re-absorption ; then absolute quiet is of the greatest 
importance. Inhalations of chloroform are used, with 
full doses of chloral and bromide of potassium given 
internally. 

Precautions. 

In giving strychnine, the possibility of its cumulative 
action must always be kept in mind as a grave feature. 
It is more likely to develop if the medicine is in pill 
form than if in solution. With the liquid preparation 
of iron, strychnine, and quinine, the danger exists also, 
as the strychnine is apt to precipitate. It must always 
therefore be well shaken. Strychnine is more effective 
in old people. 

The first constitutional symptoms are to be looked for 
with care : twitching, trembling, starting, or stiffness of 
the muscles. It is of great importance to know exactly 
when they begin, especially when, as is often the case, 
the orders received are to push the medicine to the 
utmost limit. 

Preparations of Nux Vomica. 

Abstractum Nucis Vomicae. 
Abstract of Nux Vomica. 
Dose, gr. i.-ii. 

Tinctura Nucis Vomicae. 
Tincture of Nux Vomica. 

Strength, 20 per cent. Five minims of the tincture 
represent 2 -J- 7 grain of strychnine. 

Dose, Til, x.-xxv. (TH, x. = gtt. xxv.). 



THE VEGETABLE KINGDOM. 157 

Extractum Nucis Vomicae Fluidum. 
Fl. Ext. of Nux Vomica. 

Dose, TTi ii.-iii. (Til x. = gtt. xxv.). 
Extractum Nucis Vomicae, in pill. 

Dose, gr. \-\. 

All preparations of nux vomica are given before meals. 

Preparations of Strychnine. 

Strychninae Sulphas. 
Sulphate of Strychnia. 

Dose, gr. -fa-fa {% x. = gtt. x.). 
Ferri et Strychninae Citras. 
Citrate of Iron and Strychnine. 

Dose, gr. i.-iii. 
Syrupus Ferri, Quininae, et Strychninae Phosphatum. 
Syrup of the Phosphate of Iron, Quinine and Strychnine. 

One part strychnine to 2,500. Dose, 3 i.-ii. 

Nat. Ord. Apocynacece. 
Strophanthus (Arrow-Poison). 

The seeds of strophantus hispidus, of Africa. The 
active principle is a glucoside named strophantin. It 
exists in the seeds in a strength of 8 or 10 per cent. 

Physiological Actions. 

Strophanthus enters the blood and acts directly on 
muscular tissue as a tonic, increasing its contractile 
power, and, in poisonous doses, paralyzing and leaving 
it in a state of tetanic-like spasm, — not through the 
agency of the nervous mechanism, but by direct influ- 
ence on the muscle itself. This tonic and stimulant 
action is quickly felt by the heart, receiving as it does in 
a short time all the blood of the body, and thus feeling 
the action of the whole amount of strophanthus con- 
tained in it. The beats become less frequent and the 
cardiac contractions strengthened. 



158 MATERIA MEDIC A FOR NURSES. 

Strophanthus resembles digitalis in its action on the 
heart, tut it is not as lasting a stimulant, though acting 
more quickly. It differs from it also in not affecting the 
vaso-motor nerves. It is not irritating to the alimentary 
canal, and is not cumulative. It acts as a diuretic by 
increasing the supply of blood to the kidneys. 

Preparations. 

Tinctura Strophanthi. 

Dose, TTl v.-x. (HI x. = gtt. xx.). 
Strophanthin, for hypodermic use. 

Dose, gr. sVirV 

Nat. Ord. Solanacece. 
Belladonnas Foiia ; Belladonnas Radix. 
Deadly Nightshade. 

The leaves and root of atropa belladonna, a perennial 
plant, native of Great Britain, and cultivated in this 
country. Belladonna contains two alkaloids : bellado- 
nine, of no special importance ; and atropine, the active 
principle, to which the medicinal and poisonous proper- 
ties of the drug are owing. 

Physiological Actions. 

Alone or in a watery solution belladonna (or atropine) 
is not absorbed by the skin, but when combined with 
alcohol, glycerine, or camphor, it is readily so absorbed, 
and even more quickly by mucous membranes and in- 
flamed surfaces ; so that physiological symptoms, from 
the first slight dryness of the throat to evidence of severe 
poisoning, may be produced by external applications. 

Used in this way, belladonna acts upon the ends of 
the sensory nerves as an anaesthetic, relieving pain, as 
is seen in the action of belladonna plasters. This seda- 
tive power, exerted over the nerves which control the 
sweat glands, produces the familiar effect of drying up 
the secretion of milk and checking the action of the skin. 






THE VEGETABLE KINGDOM. I 59 

Taken internally, belladonna enters the blood and 
reaches the tissues with rapidity ; and in the case of 
atropine alone absorption is even more quickly accom- 
plished. Elimination takes place by the urine, and 
quickly, atropine appearing unchanged in from ten to 
twenty hours. 

The stimulant and tonic powers of belladonna, 
which are very strong, are exerted over the whole sym- 
pathetic system and unstriped or involuntary muscular 
fibre ; and its sedative, anodyne actions are directed 
toward the motor system. It is a mydriatic, dilating 
the pupils ; an anti-spasmodic, and the most important 
respiratory stimulant known, keeping up the activity 
of the respiratory centre while at the same time allaying 
the irritability of the respiratory nerves. 

It has but little control over severe pain, and is not, 
strictly speaking, an hypnotic, though it sometimes acts as 
one indirectly by removing conditions which prevented 
sleep. It has a peculiar effect on the brain, causing ex- 
citability and in large doses narcotism. 

As a cardiac stimulant it weakens the force of the 
inhibitory apparatus, derived from the cerebro-spinal 
system, which retards the heart ; and promotes the 
activity of the accelerator apparatus, derived from the 
sympathetic system, which excites the heart. 

The secretion of saliva is checked by belladonna, and 
this causes a dryness of the mouth and throat which is 
diagnostic and is watched for as one of the first signs of 
constitutional impression. 

When small doses of belladonna or atropia are given, 
the respirations become deeper and more frequent. 
The pulse, at first slowed for a short time, afterwards 
becomes strong and rapid, its rapidity being somewhat 
out of proportion to the rate of the respirations. 

After full doses it may rise as high as twice its former 
number of beats. The small vessels are more energeti- 
cally contracted, and with the impetus to the circulation 
the temperature rises \° or i°. The pupils are dilated 
and vision disordered ; the face flushed ; the mouth 
and throat are dry ; the tongue is red ; swallowing is 



l6o MATERIA MEDIC A FOR NURSES. 

difficult ; thirst is present, and a feeling as of a ye 
throat. 

Symptoms of Poisoning. 

With larger doses the flush becomes a uniform bright 
red, and resembles the rash of scarlet-fever, except that 
it is not punctated. 1 It spreads first over face and neck, 
extending perhaps over the whole body, and is due to a 
reaction and paralysis of the vaso-motor nerves follow- 
ing the primary stimulation. 

The pupils are bright and widely staring. Headache 
and vertigo, restlessness, illusions, and delirium appear. 
The delirium of belladonna is of a peculiarly active, 
talkative, busy type, accompanied frequently by laughter 
and gayety and associated with physical lassitude. The 
patient is sometimes absorbed with spectral illusions and 
visions, without showing any fear. Occasionally he 
becomes furious, quarrelsome, and maniacal. 

With larger poisonous doses there is loss of muscular 
power, beginning in the lower extremities and becoming 
complete. Sensation is not lost. With excessive pois- 
onous doses convulsions may appear, and shortly before 
death stupor and paralysis develop, and the temperature 
becomes subnormal. The urine, at first increased, 
diminishes and may be entirely suppressed. Death 
results from asphyxia, from the failure of the respiratory 
organs, and there is heart failure as well. 

The smallest fatal dose is not positively known. 
Alarming symptoms have been produced by gr. ^ — ■%-§ 
of atropine, and death in fatal cases has occurred as 
early as five hours after taking the poison. 

Treatment of Poisoning. 

The first necessity is to use emetics or the stomach- 
pump. The bladder must be emptied at regular intervals 
to prevent re-absorption. Tannic acid is given ; and 

1 Having the appearance of being formed by exceedingly minute 
dots or points of red. 



THE VEGETABLE KINGDOM. l6l 

external heat, mustard baths, hot and cold affusions to 
the head, and artificial respiration used. 

Incidental Effects. 

Medicinal doses sometimes produce mild delirium, or 
a feeling of thirst and feverishness. The local applica- 
tion of the drug to the eye sometimes causes an inflam- 
mation on the face about the eyelids. The rash of 
belladonna may appear after small doses, and may 
desquamate ; and a bluish color may be noticed on the 
lips. The dryness of the throat is always to be looked 
for. Children bear belladonna well. 



Preparations of Belladonna. 

Tinctura Belladonnae. 
Tincture of Belladonna. 

From the leaves. Strength i in 6.66. Dose, TT[ x.-xxx. 
(TTl x. = gtt. xxv.). 

Extractum Belladonnae Alcoholicum. 
Alcoholic Extract of Belladonna. 
Dose, gr. £-|. 

Extractum Belladonnae Fluidum. 
Fluid Extract of Belladonna. 

From the root. Dose, "fil i.-ii. (TT[ i. = gtt. h\). 

Emplastrum Belladonnae. 
Belladonna Plaster. 

Equals in strength its weight of belladonna root. 

Atropina. 
Atropine. 

Dose, gr. T \. 

Atropinae Sulphas. 

Sulphate of Atropine. 

Usually given hypodermically, being very soluble in 

water. Dose, gr. T io— eVC 7 ^ x - = g tt: - x -)- 
ii 



1 62 MATERIA MEDICA FOR NURSES. 

Stramonii Folia ; Stramonii Semen. 

Thorn Apple ; Jamestown Weed. 

The leaves and seeds of daturia stramonium, a weed 
of this country and Great Britain. The active principle 
is an alkaloid named daturine, which is said to be a com- 
bination of atropine and hyoscyamine. 

Physiological Actions. 

Stramonium resembles belladonna very closely in its 
actions. By small doses' the pulse rate is increased, ar- 
terial tension raised, and the respiration quickened. It 
is a mydriatic, and has some power to relieve pain. One 
difference between them is that stramonium is more de- 
pressing to the bronchial nerves. 

The action on the intestinal muscular fibre is the same 
in both ; small doses increasing, and large ones diminish- 
ing, peristalsis. By large doses the tension of the ves- 
sels is relaxed, the pulse still remaining frequent, and 
showing a tendency to intermit. 

Symptoms of Poisoning. 

The symptoms of poisoning are much alike — dilated 
pupils, heightened temperature, rapid pulse, scarlet rash, 
restlessness, delirium, and convulsions, with the fatal 
termination preceded by stupor, paralysis, and asphyxia. 
The pulse in stramonium poisoning is much more in- 
clined to irregularity than in atropine poisoning. The 
treatment is the same. Accidental cases are common 
among children. 

Preparations of Stramonium. 

Extractum Stramonii. 
Dose, gr. J-J, 

Extractum Stramonii Fluidum. 
Fluid Extract of Stramonium. 
Dose, ttj, i.-ii. 



THE VEGETABLE KINGDOM. 1 63 

Tinctura Stramonii. 
Tincture of Stramonium. 

Strength, 10 per cent. Dose,TTt x.-xx. ("TTl x. = gtt.xx.). 

Stramonii Folia. 
Stramonium Leaves. 

Prepared in the form of cigarettes. They are smoked 
and the smoke inhaled, having an anti-spasmodic 
influence. 



Hyoscyamus (Henbane). 

The leaves of the second year's growth of hyoscyamus 
niger, a coarse plant native in Great Britain and natural- 
ized in the United States. The active principles are two 
in number — hyoscyamine, a crystalline, and hyoscine, 
an amorphous, alkaloid. These principles have the 
same chemical formula as atropine, yet are not identical 
with it. 



Physiological Actions. 

Hyoscyamus is a mydriatic, and has very much the 
same physiological actions as belladonna and stramo- 
nium. It has greater calmative and hypnotic powers 
than either of the others, due, it is stated, to its hyoscine, 
which is supposed to be much stronger than hyoscya- 
mine, and to have marked qualities as a cerebral seda- 
tive. 

Like the two former drugs, it is a cardiac and respi- 
ratory stimulant, the pulse under its influence being 
more regular than the pulse of daturine. It has the same 
stimulant action on the muscular fibres of the intestines, 
thus being somewhat laxative. In poisoning, the dry 
mouth, flushed face, dilated pupils, and busy delirium 
are the same as with belladonna and stramonium, and 
the treatment is the same. Hyoscyamine is rapidly ex- 
creted by the urine. 



164 MATERIA MEDIC A FOR NURSES. 

Preparations of Hyoscyamus. 

Tiuctura Hyoscyami. 
Tincture of Hyoscyamus. 

Made in a strength of 1 in 6.66. Dose, 3 ss.-ii. 

Extractum Hyoscyami Alcoholicum. 
Alcoholic Extract of Hyoscyamus. 
Dose, gr. i.-iii. 

Hyoscyaminae Sulphas. 
Sulphate of Hyoscyamine. 
Dose, gr. -fa-L 

Hyoscinae Hydrobromas. 
Hydrobromate of Hyoscine. 

Hyoscine is a powerful hypnotic, and differs from 
atropine in reducing the pulse rate. This is the first 
evidence of its action, and is shown in a few moments. 
The fall may be from 8 to 20 beats in a moment, and this 
effect is the last to disappear. Hyoscine does not al- 
ways dilate the pupils. It is eliminated by the urine. 

Dose, gr. T U-j\- 

Duboisia. 

An Australian plant, duboisia myoporoides. It is not 
officinal. It contains an alkaloid, duboisine, similar in 
chemical composition, and in many of its actions, to 
atropine. 

It is less irritating to the conjunctivae than atropine, 
dilates the pupil more quickly, and its effect dies away 
sooner. Frontal headache, giddiness, ringing in the 
ears, and restlessness while sleeping are among the inci- 
dental effects of duboisia. 

The quickened pulse, heightened arterial tension, 
flushed face, dry throat, and thirst are like the symp- 
toms of atropine. A few hours after administration the 
pulse falls, and a condition of quiet ensues, favorable to 
sleep. 



THE VEGETABLE KINGDOM. 1 65 

Preparations of Duboisia. 

Extractum Duboisiae. 
Extract of Duboisia. 
Dose, gr. \-\. 

Duboisinae Sulphas. 
Sulphate of Duboisia. 
Dose, gr. T h-iV 

Tinctura Duboisiae. 
Tincture of Duboisia. 

Dose, ttl v.-xx. (Tf], x. = gtt. xx.). 

Tabacum (Tobacco). 

The leaves of nicotiana tabacum, a native of tropical 
countries cultivated in the North. 

They contain an exceedingly powerful alkaloid, nico- 
tine ; a volatile oil, nicotiana ; and, in slight propor- 
tions, the following alkaloids, some of which are familiar 
as being found in other plants : lupuline, coniine, lobe- 
line, piperidine, pyridine, muscarine, and sparteine ; also 
the alkaloidal compound trimethylamine. 

Tabacco smoke contains but little nicotine, if any, 
and a large proportion of pyridine. 

Nicotine is one of the most violent poisons known, 
acting almost as rapidly as prussic acid. 

Death has followed a toxic dose in three minutes. 
Emetics, tannin, and artificial respiration, are to be 
employed in treating the poisoning. Tobacco is no 
longer used in medicine, being seriously depressing in 
its effects. 

Nat. Ord. Scrophulariace<z. 
Digitalis (Purple Foxglove). 

The leaves of the second year's growth of digitalis 
purpura, native of Great Britain, and cultivated in this 
country. 



1 66 MATERIA MEDICA FOR NURSES. 

The active principle, digitalin, occurs in two forms, 
one amorphous and the other crystalline, and is com- 
posed of four glucosides. Digitalin is no longer offi- 
cinal, the preparations made from the whole leaf being 
considered more trustworthy. 

Physiological Actions. 

The most important action of digitalis is as a heart 
Stimulant and tonic, and is shown in the slowing and 
strengthening of the pulse. This is partly brought about 
by a direct action on the heart-muscle, by which the 
circulation in the organ itself is more efficiently carried 
on ; partly by a strengthening of the inhibitory apparatus, 
which tends to slow the heart ; and partly by a stimulant 
action on the vaso-motor system, by which the arteries 
are more strongly contracted, and, by offering some 
resistance to the force of the heart, excite it to greater 
effort. The result of all this is, that the diastole is 
lengthened, and the systole becomes more energetic. 
Thus the ventricles are better filled and more thoroughly 
emptied, and the beats, reduced in number, gain in 
firmness and strength. 

When an excessive amount is taken, signs of over- 
stimulation appear, marked by intermittency of the 
pulse or by a fall below normal ; it may be to 40 or 
50 in a minute. In this condition any sudden exertion, 
such as sitting upright, may bring to a climax the grow- 
ing exhaustion of the heart, and the pulse may run up 
to 150 or more, becoming small, weak, and irregular. 
For this reason patients taking digitalis continuously 
must be kept quietly in bed and not allowed to sit up or 
to make any sudden exertion. 

In taking it only occasionally or for a short time there 
is not the same danger. 

Digitalis is also a diuretic, acting through an influ- 
ence on the renal as well as on the general circulation, 
and for this purpose it is also used locally in the form of 
poultices applied over the kidneys, and made from the 
leaves or with the fluid preparations. Digitalis is elimi- 



THE VEGETABLE KINGDOM. 1 67 

nated by the urine, and much more slowly than it is 
absorbed into the system. For this reason, if doses are 
given close together, part of the influence of one may be 
added to that of the next, and the action is intensified 
by so much. But except conditionally in this way, a 
cumulative action of the drug is not acknowledged by 
all authorities. 

Symptoms of Poisoning. 

In cases of poisoning the symptoms begin with violent 
and repeated vomiting of mucus and bile. There is a 
feeling of vertigo, pain, and heat in the head, and dis- 
turbance of vision, fringes of color with a vibratory motion 
being sometimes seen around objects. 

The face is pale, the eyes staring and prominent, 
with dilated pupils and a blue color of the sclerotics. 1 

There is sometimes salivation, and usually diarrhoea. 
The urine may be suppressed. The vomiting continues, 
and great prostration follows. The pulse is irregular, 
small, and weak, yet the beat of the heart may be hard 
and strong. The respirations become rapid and feeble. 
Pains in the limbs and back may be present. There are, 
usually before the end, delirium and stupor, or convul- 
sions. Death occurs from general failure of the circula- 
tion with final paralysis of the heart, and has taken 
place as soon as three- quarters of an hour after taking 
the poison. The average time, however, is one or two 
days. Digitalis poisoning of an acute form is not com- 
mon, and in the majority of cases the patient recovers. 
The smallest fatal dose is not known. Twenty grains 
of the extract are known to have caused death in ten 
days. 

Treatment of Poisoning. 

Emetics and cathartics must be given, and tannin in 
large quantities. Alcoholic stimulants are used, but with 
great care, and the most perfect rest and quiet, with a 
perfectly horizontal position, maintained. 

1 The whites of the eyes. 



1 68 MATERIA MEDIC A FOR NURSES. 

Incidental Effects. 

Digitalis is very bitter, nauseating, and irritant to the 
stomach, and is apt to interfere with digestion, and to 
cause vomiting, with occasional diarrhoea, marked by 
green discharges. These two latter symptoms may also 
be produced by hypodermic administration of the drug. 

Headache and vertigo, fainting, sneezing, and buzzing 
in the ears, are caused by overdoses ; also sparks before 
the eyes and other disturbances of sight ; sleeplessness ; 
fall of temperature ; and irregularity or threadiness of the 
pulse. 

Preparations of Digitalis. 

Infusum Digitalis. 
Infusion of Digitalis. 

Strength, i to 66.6. Dose, 3 i.- ? ss. More diuretic 
than stimulant. To be largely diluted. 

Tinctura Digitalis. 
Tincture of Digitalis. 

Strength, i to 6.66. Dose, "fll v.-xx. (TTJ, x. = gtt. xx.). 

Extractum Digitalis Fluidum. 
Fluid Extract of Digitalis, 

Dose, "ni i-ii. (TTL i. = gtt. ii.). The tincture and fluid 
extract are more stimulant than diuretic, and are only 
slightly diluted when given. 

Digitaline. 

Dose, gr. -^V It nas been used hypodermically, but is 
irritating and much more liable to cause abscesses than 
either the tincture or the fluid extract given in the same 
way. 

Nat. Ord. Labiatce. 
Oleum Lavandulae (Oil of Lavender). 

An oil obtained from the flowers of lavandula vera. 



THE VEGETABLE KINGDOM. 1 69 

Tinctura Lavandulae. 
Tincture of Lavender. 

May be pleasantly used, in small quantity, added to 
water for bathing. 

Spiritus Lavandulae Compositus. 
Compound Spirits of Lavender. 

A stomachic and cordial. Dose, 3 ss.-ii. 

Oleum Menthae Piperita^ (Oil of Peppermint). 

The oil of the fresh flowering mentha piperita. 
Aqua Menthae Piperitae. 

Used as a carminative. Dose, tt[ x.-xx., in water 
(Til x. = gtt. x.). 

Menthol. 
Peppermint Camphor. 

A stearoptene obtained from peppermint oil. Used 
as a local anaesthetic in headache, in the form of a 
pencil. 

Thymol. 

A stearoptene from the volatile oils of thymus vulgaris 
and other herbs. It is an antiseptic and germicide, 
resembling carbolic acid and oil of turpentine in action, 

Nat. Ord. Polygonacea. 
Rheum (Rhubarb). 

The root of several varieties of rheum, from China. 

Rhubarb contains cathartic acid, a peculiar tannic 
acid, a yellow coloring matter, etc. 

Rhubarb acts entirely on the alimentary canal. In 
small doses it is Stomachic, strengthening appetite and 
digestion. In large doses it is a cathartic, with as- 
tringent after-effects. 

In its purgative action the liver is stimulated as well 
as the intestinal glands, and evacuation takes place in 
six or eight hours, accompanied by some griping pain. 



I70 MATERIA ME DIC A FOR NURSES, 

Preparations of Rhubarb. 

Extractum Rhei Fluidum. 
Fluid Extract of Rhubarb. 

Dose, th, xv.-xxx. (TH, x. = gtt. xx.). 
Syrupus Rhei. 
Syrup of Rhubarb. 

Dose, for infants, 3 i. 
Tinctura Rhei. 
Tincture of Rhubarb. 

Dose, 3 i.-ii. 

JVal. Ord. Lauracece. 

Camphora (Camphor). 

A stearoptene obtained from the wood of laurus 
camphora, of China and other Eastern countries. 

Camphor is one of the most widely diffused of all 
vegetable substances. It is found in pennyroyal, hemp- 
tops, and numbers of other plants. 

Physiological Actions. 

Externally applied, camphor is irritant, stimulating 
the local circulation. It has feeble antiseptic power, 
and is sedative to the nerves after first stimulating them. 
Internally, it acts as a carminative and anti-spas- 
modic, gives increased force and fulness to the pulse, 
and stimulates the cerebro-spinal nerves. When large 
doses (gr. xx.-xxx.) are given, the pulse falls, and a feel- 
ing of lassitude and giddiness is produced. 

Symptoms of Poisoning. 

After poisonous doses (gr. xxx.-lx.) there are faintness 
and headache, vertigo, confused ideas, burning pain in 
the stomach, delirium, convulsions, and insensibility. 
The pulse is small, sometimes slow, again accelerated. 
The skin is pale, cold, and covered with perspiration. 
No death of an adult has occurred with camphor. 



THE VEGETABLE KINGDOM. 171 

Preparations. 

Aqua Camphorae. 

Strength, 1 to 125. Dose, § ss.-ii. 
Spiritus Camphorae. 

Strength, 1 to 10. Dose, 3 ss.-i. 
Linimentum Camphorae. 

Olive oil, 6 parts ; camphor, 1 part. 
Linimentum Saponis. 
Soap Liniment. 

Soap, 10 parts ; camphor, 5 ; alcohol, 70 : oil of rose- 
mary, and water to 100 parts. 

Oleum Camphorae. 

More stimulating than the other preparations. Dose, 
Til v.-x. (TTi x . = gtt. xx.). 

Nat. Ord. Aristolochice. 

Serpentaria (Snakeroot). 

The dried rhizome and rootlets of two or three varie- 
ties of aristolochiae, found in North America. The taste 
and odor resemble camphor. It contains a resin, a vola- 
tile oil, bitter principle, etc., and is a stimulant tonic. 

Preparations. 

Tinctura Serpentariae. 

Strength, 10 per cent. Dose, 3 i- — ii- 
Extractum Serpentariae Fluidum. 

Dose, TT[ xx. 

To be given half an hour before meals. 

Coto Bark. 

The bark of trees found in South America, somewhat 
similar to the cinchona, having an aromatic resinous odor 
and pungent taste. It contains a bitter principle, cotoin, 



172 MATERIA MEDIC A FOR NURSES. 

and has astringent action. It is irritant to the skin and 
mucous membranes. 
Extractum Coto Fluidum. 

Dose, TFX i.-xv. {y\ x. = gtt. xx.). 

Should be given in wine or other dilute alcohol, as it 
does not combine with water, but forms a precipitate. 
Cotoin. 

Dose, gr. J-ii. 

Nat. Ord. EuphorbiacecE. 
Cascarilla. 

The dried bark of croton eleuteria, from the Bahamas. 
It contains resins, volatile oils, tannin, a bitter principle, 
named cascarillin, etc. It is an aromatic bitter. 

Infusum Cascarillae. 
Infusion of Cascarilla. 

Strength, § i.-Oj. Dose, a wineglassful before meals. 

Oleum Tiglii (Croton Oil). 

A fixed oil, obtained from the seeds of croton tiglium, 
a shrub of Asia. The oil is quite thick and becomes 
more so with age ; deteriorates rapidly in quality and 
should not be kept long, but, if possible, always obtained 
fresh. In color it may vary from a pale yellow to a dark 
reddish-brown. The taste is acid and hot. 

It is a very complex substance, containing several fixed 
oils and volatile acids. It is supposed to contain a vesi- 
cating principle and a distinctly purgative one, but the 
latter has not yet been obtained separate from the others. 
Croton oil is soluble in alcohol. 

Physiological Actions. 

It is a very powerful irritant and vesicant when ex- 
ternally applied, causing burning and redness of the skin 
and an eruption of papules, which in a short time be- 
come pustular. Taken infernally it irritates actively ; 



THE VEGETABLE KINGDOM. 173 

causes burning in the throat and epigastrium, and has 
a very rapid action as a drastic and hydragogue 
cathartic. 

The bowels are first opened in one or two hours after 
it is taken, and catharsis re-occurs several times within 
twelve hours or more, with great thoroughness, some 
pain, and, usually, a decided degree of prostration. 

The dose, which is usually one or two drops — some- 
times three or four — may be given on bread-crumbs, or in 
a little glycerine, or on a lump of sugar. 

With unconscious or delirious patients it maybe placed 
directly on the back of the tongue. 

In applying it externally, the amount ordered is taken 
on a bit of flannel, and rubbed into the prescribed spot 
on the skin until there is well-marked redness. The 
eruption appears usually in about four hours ; if it does 
not, the application is repeated. 

It may also be mixed with olive oil or turpentine, 
or combined with liniments, alcohol, or ether. 

The eruption remains for several days, and may, on 
disappearing, leave small cicatrices * behind it. 

Symptoms of Poisoning. 

Though so active in small doses there have not been 
many known instances of fatal poisoning by croton oil. 
Large doses usually provoke immediate vomiting, but 
symptoms when developed are those of gastro-enteritis, 
with violent catharsis and great prostration. 

In some instances, instead of acting in the usual, way it 
seems to be absorbed into the blood, and produces nerv- 
ous symptoms, such as palpitation and restlessness, head- 
ache, giddiness, and confusion of ideas. 

Oleum Ricini (Castor Oil). 

The oil expressed from the seeds of ricinus communis, 
of Calcutta. Castor oil contains several fatty acids, of 
which ricinoleic acid is peculiar to itself. 

1 Scars. 



1/4 MATERIA ME DIC A FOR NURSES. 

Physiological Actions. 

Externally castor oil is very soothing, and may be 
applied to the eye, or the surface, as a sedative and 
protective. 

Internally it is vmirritating to the stomach, if pure, but 
if impure or rancid it may cause nausea and vomiting. 
Aside from this, the odor may provoke nausea even be- 
fore the drug is swallowed, and all pains should be taken 
to avoid this possibility, by preparing it carefully and hold- 
ing it at the side — not under the patient's nose — until the 
moment comes for swallowing it. 

In the intestines it acts as a simple purgative, and 
here the oil which is not perfectly pure is more efficient. 
It is painless, with sedative and somewhat constipating 
after-effects. 

The muscular coat and the glands of the intestines are 
stimulated, and evacuation results in from three to six 
hours — sometimes sooner. 

It is not a hydragogue cathartic, as it does not appreci- 
ably increase the intestinal secretions. It does not act on 
the liver. 

Ricinoleic acid enters the blood and tissues and is 
removed by all secretions, including the milk, and in 
this way purgation may be produced in a nursing infant. 

Castor oil is very nauseous, and needs to be carefully 
administered, in order that it may be as little offensive 
as possible. To children it is best given in hot sweet- 
ened milk, and adults may take it well in this way ; or 
it may be poured into the centre of an equal quantity of 
glycerine, or given in a little hot coffee, or in brandy ; 
first wetting the sides of the glass, and pouring the oil 
carefully in the centre of 3 ss. brandy, then covering it 
with as much more. In all cases it will be more easily 
taken if the mouth be first rinsed out with brandy or 
peppermint, or any thing pungent which will blunt the 
sense of taste. A little carbonated water afterwards is 
gratefully received, or, to those who like olives, nothing 
is more acceptable after nauseating, or bitter medicines, 
than an olive, when it may be given. 



THE VEGETABLE KINGDOM. 1 75 

Castor oil can be had put up in soft flexible capsules, 
which, though large, are easily swallowed. 

Dose, | ss.-i. 

Dose for infant one year old, 3 i- — ii- 

The castor bean is very poisonous. The leaves are 
used as a poultice, applied to the breasts to increase the 
flow of milk. 

Nat. Ord. Salicacece. 
Salicinum (Salicin). 

A glucoside, obtained from the bark of various species 
of salix or willow tree ; and from gaultheria procumbens 
or wintergreen. 

Salicin is a bitter tonic, and to some extent an anti- 
pyretic and antiseptic. Its qualities resemble, though 
in a very mild degree, those of salicylic acid, which is 
derived from it. 1 Salicin is not poisonous. It is very 
insoluble, and is given dry on the tongue or in capsules. 
Dose, gr. xx. 

Nat. Ord. Urttcacece. 
Lupulus (Hops). 

The dried strobiles 2 of humulus lupulus, or hop vine, 
cultivated in England. They contain an aromatic vola- 
tile oil, valerol ; a bitter principle, lupulinic acid, etc. 

The former gives a stimulant action, with after- 
effects that are sedative and sleep-producing. The 
latter gives stomachic and tonic qualities. Hops are 
also slightly astringent. These various characteristics 
are shown in ales and beers, which are made from hops. 
The heart action is somewhat strengthened and quick- 
ened by hops, and diaphoresis produced. 

Hops are used externally for the relief of pain, either 
as a means of applying moist heat, when they are put 

1 See carbon compounds for salicylic acid. 

2 Cones ; from the Latin word, meaning a pine cone. 



I?6 MATERIA MEDIC A FOR NURSES. 

into bags and wrung out of hot water ; or as dry heat, 
when — also in bags — they are heated through. 

Tinctura Humuli. 
Dose, 3 ss.-ii. 

Extractum Lupulini Fluidum. 
Dose, 3 ss.-ii. 

Hop pillows may be used as a means of inducing 
sleep. The crackling of the hops, which may annoy, 
may be stopped by sprinkling them with alcohol. 

Nat. Ord. Coniferce. 
Oleum Terebinthinse (Oil of Turpentine). 

The oil distilled from the oleo-resin turpentine, which 
is obtained from several varieties of pines, chiefly those 
growing in the Southern United States. 

Turpentine, as such, is not used in medicine. It may 
be separated into the oil and a resin, which, combined 
with lead plaster, forms adhesive plaster. 

Physiological Actions. 

Externally oil of turpentine is Stimulating and very 
irritant, causing redness and heat followed by vesica- 
tion. Its action as a counter-irritant needs to be watched 
with much care, as severe blistering, with depression of 
the general system, may result if its application be too 
long continued. Turpentine is absorbed by the whole 
skin, and enters the blood unchanged. 

Internally in moderate doses its immediate action is 
slightly antiseptic and stimulant to the blood-vessels. 
On the nerves it acts locally as a sedative, and in the 
intestines stimulates the muscular coat, and is, in larger 
doses, a purgative. 

It is a carminative, expelling gas from the intestines, 
and this result is produced as well by outward applica- 
tions and by enemata as when given by mouth. It 



THE VEGETABLE KINGDOM. I 77 

is also an anthelmintic, and is given inenemata for 
thread-worm. 

It is a stimulant diuretic, producing in large doses 
active irritation or congestion of the urinary organs, 
with pain, or it may be strangury or hsematuria. The 
strength and rapidity of the pulse are increased by 
turpentine. 

In large doses it has a sedative effect on the brain and 
spinal cord, shown by heaviness and drowsiness, an un- 
steady gait, and debility. The temperature is lowered 
slightly. It is eliminated by the kidneys and lungs, 
giving its own odor to the breath, and the odor of 
violets to the urine. 

Turpentine is capable of causing death, but fatal 
cases are very rare, and there are but few instances even 
of serious poisoning. 

Symptoms of Poisoning. 

The symptoms recorded in such cases include usually 
vomiting and purging, though they do not always exist. 
The pupils are dilated ; the pulse rapid, weak, and 
irregular. The skin may be either dry or moist ; the 
urine diminished or suppressed altogether, or containing 
blood. In most cases unconsciousness is complete. 

Death in one instance was supposed to have followed 
a dose of § vi., but recovery has taken place in other 
cases after doses nearly as large. 

Oleum Terebinthinae. 
Oil of Turpentine. 
Dose, TT|, x.-xx. 

It may be given on a lump of sugar. The oil and 
spirits of turpentine are the same, the only difference 
being that spirits have been redistilled. 
Sanitas. 

A disinfectant fluid, put up for use in sick-rooms. It 
is made with oxydized turpentine, and contains per- 
oxide of hydrogen as active principle. It does not stain 
clothing. 
12 



178 MATERIA MEDICA FOR NURSES. 

Oleum Juniperi (Oil of Juniper). 

The oil from the full-grown unripe fruit of juniperus 
communis. 

Juniper resembles turpentine in many of its actions, 
but is less powerful and also less disagreeable. It is a 
stomachic stimulant, and diuretic. In large doses 
it inflames the kidneys and produces strangury. 

Dose, TTI v.-xv. (ill, x. = gtt. xx.). 

Nat. Ord. Zingiberacea. 
Zingiber (Ginger). 

The scraped and dried root-stock of zingiber offici- 
nale. 

Ginger contains an aromatic volatile oil, and is used as 
a carminative. 

Tinctura Zingiberis. 
Tincture of Ginger. 

Strength, 1 to 8. Dose, TTJ, xv.-xxv. (TT|, x. = gtt. xx.). 

Nat. Ord. Liliacece. 
Scilla (Squill ; Sea-Onion). 

The bulb of scilla maritima, a plant of Southern 
Europe. 

Squill increases the strength and reduces the frequency 
of the heart action ; contracts the arterial system and 
raises blood pressure. It is diuretic by means of its ac- 
tion on the circulation in the kidneys, and a stimulant 
expectorant, increasing the bronchial secretion by im- 
proving the local circulation, and aiding in the expulsion 
of the mucus. 

In overdoses it' is irritant, and may cause inflamma- 
tion of the kidneys, with strangury and bloody urine, or 
suppression. It is also irritant to the stomach and intes- 
tines, and even in medicinal doses may disorder diges- 
tion. Full doses cause nausea, vomiting, and diarrhoea. 



THE VEGETABLE KINGDOM. 1 79 

Symptoms of Poisoning. 

Fatal poisoning has been caused by squill, in which 
these symptoms were present in an aggravated form, with 
marked depression of the pulse, convulsions and collapse. 
Death has resulted from a dose of 24 grains. 

Treatment of Poisoning. 

The stomach and bowels must be emptied by ipecac 
and castor oil. Large quantities of water should be given 
to overcome the suppression of urine, and the usual 
methods of treating gastro-enteritis and collapse, em- 
ployed. 

Preparations. 

Tinctura Scillae. 

Strength, 1 to 6.6. Dose, TTl x.-xx. (TTl x. = gtt. xxii.). 

Extractum Scillae Fluidum. 

Dose, TTl i.-iii (TTl i. = gtt. ii.). 

Syrupus Scillae. 
Dose, 3 ss.-i. 

Syrupus Scillae Compositus. 

Contains squill, senega, and tartar emetic. Dose, 

TTl X.-XXX. (Til X. = gtt. X.). 

Aloe (Aloes). 

The thickened juice of the leaves of aloe socotrina, 
from an island in the Indian Ocean, and Arabia. It has 
a very nauseous and bitter taste, and contains an active 
principle, aloin, which has cathartic qualities. 

Aloes is a bitter stomachic, and, as a cathartic, 
acts principally on the colon, and with extreme slowness ; 
ten or fifteen hours being required for a result if it is 
given alone. It stimulates the flow of bile to some ex- 



l8o MATERIA MEDIC A FOR NURSES. 

tent, and excites the circulation of all the pelvic organs. 
Aloes is rarely used alone, but is an ingredient of many 
well-known laxative preparations, in liquid and in pill 
form, usually in a strength of 2 or 3 grains. It does not 
cause constipation as an after-effect, but on the contrary, 
makes the intestines more sensitive. 

Tinctura Aloes. 
Tincture of Aloes. 

Strength, J ss.-Oj. Dose, 3 i.-iii. 

Tinctura Aloes et Myrrhae. 
Tincture of Aloes and Myrrh. 

Strength, f iss. of each in Oj. Dose, 3 i.-ii. 

Nat. Ord. Labiates. 
Convallaria (Lily of the Valley). 

The entire plant of the convallaria majalis, the lily of 
the valley. It contains two glucosides : one, convallarin, 
is crystalline, and has special qualities as a gastrointes- 
tinal irritant ; and the other, convallamarin, is amor- 
phous, and acts as a stimulant to the circulation. 

Physiological Actions. 

Convallaria slows and strengthens the heart, and 
raises the blood pressure ; makes the respirations a little 
more full and less frequent than ordinary, and is a very 
decided diuretic. In excessive doses the heart is dis- 
turbed and the pulse becomes irregular ; the breathing 
is forced ; deep and prolonged inspiration being pro- 
duced by spasm of the inspiratory muscles. 

When a poisonous quantity is taken, arterial pressure 
rises very high, and the pulse is correspondingly rapid, 
until shortly before death, when the pressure falls, respi- 
ration grows slow and deep, and the heart stops in sys- 
tole. Convallaria does not affect the brain. 



THE VEGETABLE KINGDOM. l8l 

Preparations. 

Extractum Convallariae. 

Dose, gr. v.-xv. 
Extractum Convallariae Fluidum. 

Dose, fU ii.-x. (TTJ, x. = gtt. xxv.). 
Convallarinum. 
Convallarin. 

Dose, gr. ss.-ii. 

Nat. Ord. Melanthacece. 
Veratrum Viride. 

Indian Poke ; Green Hellebore. 

The dried root-stock of veratrum viride, a plant be- 
longing to the Northern States of the United States. It 
yields two alkaloids, jervine and veratroidine. 

Physiological Actions. 

Veratrum viride is a powerful cardiac depressant. 

When taken in small doses the pulse is at first reduced 
in strength and later in frequency, being sometimes 
lowered to 35 or 40 a minute. The fall of the pulse is in 
constant proportion to dose taken. It is then soft, com- 
pressible, and may be moderately full, but any exertion 
may change its character and it becomes rapid, thready, 
small, and weak, being at times almost imperceptible. 
Nausea and vomiting may also be produced at this 
stage, with excessive muscular depression and weakness. 
The depressing action on the heart is the result of direct 
influence over the heart muscle, and also over the 
inhibitory apparatus. The brain is not affected. 

Symptoms of Poisoning. 

Excessive doses of veratrum viride produce violent 
and alarming symptoms, but fatal results from it are 
rare, as vomiting is usually set up immediately. The 



1 82 MATERIA MEDICA FOR NURSES. 

nausea is intense and the emesis violent ; the skin cold 
and clammy and the pulse thread-like. 

Hiccough, faintness, and vertigo, partial unconscious- 
ness, and loss of sight may be noticed among the symp- 
toms of poisoning. Recovery has taken place after a 
teaspoonful dose of the fluid extract, and, in another 
case, the same amount caused death. 

Treatment of Poisoning. 

Emesis must be encouraged, and the stomach well 
washed out with warm water. The patient should not 
be allowed to rise during the act of vomiting, but to turn 
to the side, and afterwards, lying on his back, with the 
feet higher than the head, must maintain perfect rest. 

Alcoholic stimulants are used, and external heat is of 
importance, with gentle friction to excite the capillary 
circulation. 

Incidental Effects. 

The action of the skin is increased in an indirect way 
by veratrum viride, and the secretion of bile is also stim- 
ulated. The temperature is quite markedly lowered by 
full doses, and various incidental effects, such as a feeling 
of heat and prickling, restlessness, anxiety, dizziness, 
dimness of vision, unsteady gait, a dryness of the mouth, 
with thirst, choking, nausea, and vomiting, may appear 
after medicinal doses. 

An eruption attended with itching is sometimes pro- 
duced, appearing on the face and especially round the 
mouth. With suspension of the drug this soon dis- 
appears. 

In giving veratrum, if no special orders about the 
pulse have been given, it should not be allowed to fall 
below 70. A fall below 55 is dangerous. 

Preparations. 

Tinctura Veratri Viridis. 
Tincture of Veratrum Viride. 

Strength, 50 percent. Dose, "ni iii.-vi. (fll x. = gtt. 
xxv.). 



THE VEGETABLE KINGDOM. 1 83 

Extractum Veratri Viridis Fluidum. 
Dose, m i-iii. (Til i. =gtt. ii.). 
Norwood's Tincture is a saturated tincture and is unofficinal. 

Veratrina (Veratrine). 

A compound of alkaloids contained in the seeds of 
veratrum album and sabadilla. 

It is exceedingly poisonous, and is little used internally. 
Poisonous doses cause convulsions and tetanus, with 
death from asphyxia. Externally it is irritant, causing 
prickling and tingling, redness of the skin, numbness, 
and vesication. The unguent is a powerful counter- 
irritant, but needs to be used with care, special pains 
being taken not to get it near the eyes, as it may cause 
violent irritation of the conjunctivae. 

The officinal ointment usually requires dilution. 

Preparations. 

Unguentum Veratrinae. 

Strength, 4 per cent. 
Ointment of Veratrine. 

For external use 
Oleatum Veratrinae. 
Oleate of Veratrine. 

Strength, 2 per cent. For external use. 

Cochici Semen (Colchicum Seed). 
Colchici Radix (Colchicum Root). 

Meadow Saffron. 

The dried ripe seeds and corm * of colchicum autum- 
nale, found in Europe. The active principle is called 
colchicine. 

1 A part of the stem which is underground, yet not the actual root 
— a bulb. 



1 84 MATERIA MEDIC A FOR NURSES. 

Physiological Actions. 

Colchicum is a sedative to the central nervous sys- 
tem ; a diuretic ; and an irritant cathartic. It stim- 
ulates the liver, and excites the action of the skin. The 
urine, urea, and uric acid are increased in amount by 
moderate doses of colchicum. The pulse is slightly re- 
duced in frequency — about 12 beats less to the minute 
being noticed while the impression lasts. 

Symptoms of Poisoning. 

Colchicum in poisonous doses is an acro-narcotic, 1 
producing a combination of nervous and gastro-intestinal 
symptoms. 

Nausea, violent and persistent vomiting and retching 
appear first, with purging of serous, mucous, and bloody 
matters, attended with griping pain. 

Tenderness and burning are felt in the abdomen and 
stomach ; the urine may be diminished or suppressed, 
while in some cases it is increased, and in others the 
kidneys seem unaffected almost to the last. 

Spasms occur frequently, and there may be fatal con- 
vulsions. The circulation fails, the pulse becomes rapid 
and grows feeble and thready, the skin is cold, livid, and 
covered with perspiration. 

Consciousness remains, and death results from col- 
lapse. 

The fatal dose is small, death having been caused by 
3 ii. ss. of the wine. 

Treatment of Poisoning. 

The only chemical antidote is tannin, though it is not 
always sure in its action. Emetics, with plenty of warm 
water, and castor oil must be given ; albuminous drinks 
— milk, white of egg, etc. — and demulcents freely given, 
and stimulation used as the need arises. 

1 A poison which is irritant, and which also acts on the brain and 
spinal cord. 



THE VEGETABLE KINGDOM. 1 85 

Incidental Effects. 

Colchicum, even in small doses, may produce un- 
pleasant secondary symptoms : dizziness, fulness and 
pain in the head ; pains over the body ; numbness, red- 
ness, prickling or smarting sensations ; sneezing ; running 
at the eyes ; irritated fauces ; coated tongue ; loss of 
appetite or nausea ; abdominal uneasiness or pain ; 
flatulence or borborygmi ' ; or rectal tenesmus may be 
observed. 

Preparations of Colchicum. 

Tinctura Colchici Seminis. 
Tincture of Colchicum Seeds. 

Strength, seeds, 15 parts in 100. Dose, 3 ss.— iss. 

Vinum Colchici Seminis. 
Wine of Colchicum Seeds. 

Same strength. Dose, 3 ss.-iss. 

Extractum Colchici Seminis Fluidum. 
Fluid Extract Colchicum Seeds. 

Dose, TU ii.-vi. (Tij, x. = gtt. xxv.). 

Vinum Colchici Radicis. 
Wine of Colchicum Root. 
Strength, 40 per cent. 

Dose, TTl x.-xv. (fTl x. = gtt. xx.). 
Purgative dose, 3 ss. 

Extractum Colchici Radicis Fluidum. 
Fluid Extract of Colchicum Root. 
Dose, fTl ii.-iv. (TT[ i. = gtt. ii.). 

1 Sounds made by gas in the intestines. 



1 86 MATERIA MEDICA FOR NURSES. 

Nat. Ord. Graminacece. 
Ergota (Ergot). 

Ergot is a parasite which develops in rye, taking the 
place of the grain, and having the appearance of a black- 
ish fungus. It is a complex substance, containing various 
alkaloids and acids ; a fixed oil, etc. 

Three of the alkaloids are named ecboline, ergotine, 
and ergotinum ; and the watery extract ergotin contains 
all the important constituents, and may be considered to 
represent the active principles of ergot. 

Physiological Actions. 

Ergot is specially known as an oxytocic, exciting or 
increasing uterine contractions ; and as a haemostatic. 
In the latter capacity it acts by contracting the small 
vessels, thus promoting coagulation. The frequency of 
the pulse is lessened by ergot, and very large doses 
depress the heart and vaso-motor centres and lower 
arterial pressure. 

It is not an active poison, and an ounce of the fluid 
extract has been given without producing serious symp- 
toms. 

Symptoms of Poisoning. 

In cases where poisoning has occurred the symptoms 
were thirst ; gastric irritation and diarrhoea ; a small 
pulse ; burning pain in the feet ; and sometimes tingling 
and cramps, dizziness, dilated pupils, and a feeling 
of cold. Before death there are convulsions. In Euro- 
pean countries, where the poorer classes live largely on 
rye bread, chronic ergot-poisoning is familiar, and has at 
times prevailed as a scourge. There are two varieties of 
this chronic poisoning — the gangrenous and the spas- 
modic, — but it is unknown in this country, and need not 
be described here. 



THE VEGETABLE KINGDOM. 1 87 

Incidental Effects. 

The urine, perspiration, and milk are reduced in quan- 
tity by ergot. After taking medicinal doses, one or more 
of the following symptoms may be observed : an un- 
pleasant taste in the mouth ; tickling in the throat ; 
nausea ; burning pain in the stomach or abdomen, with 
eructations of gas or diarrhoea ; headache ; lassitude ; 
giddiness ; specks before the eyes ; unsteady gait ; 
irregular pulse ; chilly feelings. 

Extractum Ergotae Fluidum. 
Fluid Extract of Ergot. 
Dose, 3 i.-ii. 

Extractum Ergotae. 
Extract of Ergot. 

Is five times as strong as the fluid ext. (which repre- 
sents gr. i. to fTi i.), as gr. i. equals gr. v. of the solid drug. 

Ergotin. 

Bonjean's preparation of ergotin is about ten or twelve 
times as strong as ergot — gr. v. or vi. representing 3 i. of 
the drug. It is used hypodermically. 

It is irritant to the tissues and may produce abscesses, 
even when deeply given. 

Preparations of ergot lose their strength if kept for 
any length of time. 

Nat. Ord. Filices. 
Filix Mas (Male Fern). 

The root-stock of aspidium filix mas, a European fern. 
The medicinal principle of fern is an oleo-resin of a bit- 
ter, nauseous taste. 

It is an anthelmintic, specially destructive to the tape- 
worm. Although less irritating than some others of its 
class, it may, in overdoses, produce severe intestinal 
irritation, and death has been caused in an adult by 
taking six ounces. 



1 88 MATERIA MEDICA FOR NURSES. 

Nat. Ord. Fungi. 
Agaricus. 

A fungus, called polyporus officinalis, white or purging 
agaric, which grows on the larch. 

In small doses it checks perspiration, the secretions of 
the bronchial tubes, the mammary glands, and the bowels. 
In large doses it is purgative. 

Agaricin. 

Dose, gr. \ to J, in pill. 

Nat. Ord. Lycopodiacece. 

Lycopodium. 

The dust, or sporules, which fills the spikes of a 
European moss. Collected in Switzerland and Ger- 
many, and used as a dusting powder for infants 
especially ; also for bed-sores, etc., either alone or mixed 
with bismuth. Lycopodium is inflammable, and is some- 
times called vegetable sulphur. It is a very soft, fine 
powder, and is used in rolling and packing pills and 
suppositories. 

THE ANIMAL KINGDOM. 
Lanolin. 

A combination of fats obtained from sheep's wool. It 
does not become rancid, nor form soaps, and is rapidly 
absorbed by the skin. 

It is used as a simple emollient, and as a means of 
introducing medicine into the system. 

Saccharum Lactis (Sugar of Milk). 

A crystallized sugar obtained by evaporation from the 
whey of milk, and specially suitable for use in preparing 
baby foods. It is soluble in one part boiling and seven 
parts cold water. 



THE ANIMAL KINGDOM. 1 89 

Fel Bovis (Ox Gall). 

Prepared by partly evaporating ox bile, adding alco- 
hol, removing the sediment, and evaporating it again to 
the consistency of an extract. 

Ox gall is used to intensify the action of purgative 
enemata. Its action is painful and very thorough. 

The amount usually ordered to be given is 3 ii.-iv. 

Pepsin. 

Pepsin is one of the normal constituents of the gastric 
juice, and, with the aid of hydrochloric acid, changes 
albumins into peptones, in which form they are readily 
diffusible and capable of being absorbed into the blood. 

Pepsin as used in medicine is a preparation made from 
the mucous membrane which lines the stomach of the 
calf, sheep, or pig. 

It is made by cleaning the mucous lining, scraping it, 
drying the pulp at a temperature of ioo° F., and pulver- 
izing it. The powder is a light yellow-brown, almost 
insoluble in water, and of slightly salty taste. It maybe 
taken dry on the tongue or given in milk. 

Dose, gr. ii.-v., with meals or immediately after. 

Pancreatin. 

A preparation made from the pancreas of the pig. 
Pancreatic extract digests starchy and proteid ' sub- 
stances, and pancreatin, while not given alone as a 
medicine, is very largely used in preparing artificially 
digested foods, viz. : pancreatized milk, eggs, oysters, 
soups, broths, etc. 

The principle followed in making pancreatized food 
is that by subjecting it to the action of pancreatin in the 
presence of moderate heat, the process of digestion takes 
place, and may be made complete or only partly so, 
according to the length of time during which they are in 
contact. 

1 Foods containing albumin, casein, gluten, gelatin, nitrogen, 
carbon, hydrogen,' and oxygen, are called proteids. 



I90 MATERIA ME DIC A FOR NURSES. 

The digestive process is stopped by heat at the boiling 
point, or by extreme cold. For this reason artificially 
digested foods, having reached the point desired, are 
either brought quickly to a boil or else are put on ice. 

Milk, if thoroughly digested, has a slightly bitter taste, 
which is not noticeable if the process has been short of 
complete. 

Adeps Praeparatus (Prepared Lard). 

Lard consists of a fluid oil, olein, with stearin and 
palmitin, which are solid oils. 

It is used as the basis of various officinal ointments. 

Benzoinated Lard. 

One part of benzoin to fifty parts of lard. 

Cetaceum Spermaceti. 

A fatty substance obtained from the head of the sperm 
whale, and resembling white wax. 
It is used as an emollient. 

Oleum Morrhuae (Cod-Liver Oil). 

The oil obtained from the liver of gadus morrhua, and 
other species of cod fish. An exceedingly complex sub- 
stance, containing glycerine, acetic acid, and several 
fatty acids, iodine, chlorine, and traces of bromine, 
phosphorus and phosphoric acid, and various other con- 
stituents. There are three varieties : the pale yellow, 
light brown, and dark. The pale oil is the purest, being 
prepared by forcing steam at high pressure through the 
livers, and is less nauseous than the dark oil. 

Physiological Actions. 

Cod-liver oil is an alterative to the general nutrition 
in various diseased conditions, and is more truly a food 



THE ANIMAL KINGDOM. I9I 

than a medicine, as it supplies the need of the tissues for 
fat. Fat produces force, and is utilized by every part of 
the body in quantities directly proportioned to the 
activity of the different tissues. The nervous system 
needs the largest amount ; the muscular, the next largest. 
Having been elaborated by the liver of the fish, cod-liver 
oil is more easily digested than other fats. 

The smell of cod-liver oil is unpleasant and sometimes 
causes nausea. This may be avoided by taking some 
peppermint into the mouth just before taking the oil, 
and by avoiding bringing it into direct line with the 
nose. All patients do not know how to take oil ; by 
tossing it into the mouth and not allowing the lips to 
touch it, it is less disagreeable. 

It is best to mix no other medicines with cod-liver oil, 
except hypophosphites. If other medicines come at the 
same time they should be given separately. It may be 
given in any of the ways in which castor oil is given ; it 
is almost always well taken if floated in a little brandy or 
wine, or lemon juice. These precautions about giving it 
do not necessarily apply to the various emulsions of oil, 
which are usually not at all hard to take. The proper 
time to administer cod-liver oil is when digestion is at its 
height. 

In overdoses, or when first taken, it may disorder the 
stomach, or cause temporary relaxation of the bowels. 
It sometimes causes an eczema. 

Emulsions of cod-liver oil spoil in a short time, and 
patients should not be encouraged to buy the ready- 
made preparations in the shops. 

In giving cod-liver oil the faeces must be watched, to 
see if any is carried away undigested. 

Dose, 3 i.- 3 ss., from three quarters of an hour to an 
hour after meals. 

Cantharis (Cantharides ; Spanish Flies). 

The dried and powdered bodies of the cantharis vesi- 
catoria, a beetle of Southern Europe. The powder is 
grayish-brown and specked with minute greenish span- 



192 MATERIA MEDIC A FOR NURSES. 

gles from the wing-cases of heads. It has a strong 
unpleasant odor. The active principle is cantharidin, 
an active irritant, besides which it contains a volatile 
oil and fatty substances. 

Physiological Actions. 

Externally cantharides is vesicant. When applied to 
the skin a feeling of heat and burning is felt in a few 
hours, and small vesicles form which unite in one large 
blister. 

The average time required for this result is about 
eight hours. The action of cantharides is attended with 
less injury to the skin than that of any other vesicant. 
No pus is formed during the healing process, and no scar 
is left by the blister. 

Internally cantharides is irritant to mucous mem- 
brane, and if given medicinally must be largely diluted. 
It enters the blood from the stomach and also from 
blistered surfaces, and is slowly excreted by the kidneys. 
In small doses it causes diuresis with some irritation of 
the urinary organs, and larger doses produce strangury. 1 

Symptoms of Poisoning. 

When a poisonous dose of cantharides is taken the 
first symptoms are burning in the oesophagus and stom- 
ach, a constricted feeling about the throat, gastric and 
abdominal pain, with vomiting and in most cases 
diarrhoea. 

If the powder has been taken the small green specks 
may be seen in the matter vomited, which is at first 
mucous, then bilious, and finally serous. The discharges 
from the bowels have the same characteristics and are 
scanty, frequent, and accompanied by tenesmus. 2 There 
is frequently salivation with swelling of the salivary 

1 Difficulty in passing urine, which comes away drop by drop, with 
pain. 

2 Frequent and painful desire for evacuation. 



THE ANIMAL KINGDOM. 193 

glands. The pulse is weak and rapid, and death usually 
occurs quickly from collapse caused by the gastrointes- 
tinal inflammation, but if it is delayed for a few hours the 
symptoms of irritation of the urinary apparatus appear, 
beginning with pains in the back, and ending in stran- 
gury, with scanty, albuminous, or bloody urine, and 
tenesmus of the bladder. 

Treatment of Poisoning. 

There is no antidote to cantharides, and the stomach 
must be at once emptied, and as thoroughly as possible 
washed out ; large quantities of albuminous and mucila- 
ginous drinks given ; warm baths to relieve the strangury, 
and stimulants if necessary. No oils or glycerine must 
be given, as they aid in the absorption of the poison. 

It is to be remembered that constitutional effects are 
sometimes produced by even a moderate blister, and if 
necessary, the blister must be removed and the part 
washed with soap and water. 

Cautions. 

Before applying a blister the spot should be washed 
with soap and water ; dried ; washed again with alcohol 
or ether, and briskly rubbed for a moment or two. 
Absorption then takes place more quickly. A blister 
should never be applied over a bony prominence, as 
sloughing may follow, the circulation in such parts being 
sluggish. On tender skins vesication is soon produced 
and the blister must be carefully watched lest the action 
be too severe. On coarse skins, or in places where it is 
thick, as on the scalp or at the knee-joint, more time is 
needed. 

Hairs must be cut away, or shaved. A blister should 
not be left on a child's skin long enough to rise, but 
should be removed when redness appears, and poultices 
be applied to finish the process. 



APPENDIX. 



RELATION OF MINIMS TO DROPS IN 
CERTAIN MEDICINAL LIQUIDS. 



(see note at end 


) 




Acetum Opii T([ 10 = gtt. 15 


Acidum Aceticum 






Tl[ IO =3 gtt. 18 


" " Dilutum 






til 10 = gtt. IO 


" Carbolicum Liquef actum 






TTL IO = gtt. l8 


" Hydrochloricum . 






TTL IO = gtt. IO 


M " Dilutum 






. Til IO == gtt. IO 


1 ' Hydrocyanicum ' ' 






Til IO = gtt. IO 


" Nitricum 






TTL IO = gtt. 17 


" Dilutum 






TTL IO = gtt. IO 


" Nitrohydrochlor. Dilutum 






TT1 IO = gtt. IO 


1 ' Phosphoricum 






til IO = gtt. IO 


" Sulphuricum Aromaticum 






17110 = gtt. 24 


'* " Dilutum . 






TTL IO = gtt. IO 


^Ether Fortior . 








TIL 10 = gtt. 30 


Alcohol .... 








TTL IO = gtt. 24 


Amyl Nitrite . 








TTL ro = gtt. 30 


Aqua Ammonise 








TTL IO = gtt. IO 


Chloroform 








TTL IO = gtt. 40 


Copaiba .... 








TTL IO = gtt. l8 


Creasotum 








TTL IO = gtt. 20 


Extractum Aconiti Fluidum 








TTL IO = gtt. 25 



195 



19° APPENDIX. 


Extractum Belladonnae Fluidui 


n . . . th, 10 = gtt. 25 


Buchu ' 




. TTJ, 10 = gtt. 25 


' ' Cinchonoe ' 




. TTl 10 = gtt. 20 


" Colchici Sem. ' 




. TTj, 10 = gtt. 25 


" Conii(Fructus) ' 




. vi 10 = gtt. 20 


' ' Convallariae ' 




. in, 10 = gtt. 25 


' ' Digitalis ' 




. TT[ 10 = gtt. 20 


4 ' Ergotae 




. Tt[ 10 = gtt. 20 


" Gelsemii ' 




. TIL 10 = gtt. 25 


" Hyoscyami 




. til 10 = gtt. 25 


" Ipecacuanhae ' 




. 1TI IO = gtt. 20 


" Nucis Vomicae ' 




. TTL 10 = gtt. 25 


" Pilocarpi ' 




. Til IO = gtt. 20 


Rhei 




. 71], 10 = gtt. 20 


" • Scillae, U. S. (with a 


lcohol), Fluidum tt^ 10 = gtt. 20 


' ' Veratri Viridis Fluic 


lum . . . TTl 10 = gtt. 25 


Liquor Acidi Arseniosi 


. TT[ 10 = gtt. 10 


" Arsenii et Hydrargyri I 


odidi . . TTj, 10 = gtt. 10 


" Ferri Chloridi 


. TTL IO = gtt. 12 


" Ferri Nitratis 


. til 10 = gtt. 10 


" Potassii Arsenitis . 


. til IO = gtt. IO 


' ' Sodii Arseniatis . 


. til IO = gtt. IO 


Oleum Amygdalae Amarae 


. TIL IO = gtt. 20 


" Anisi . 


. til IO = gtt. 20 


" Caryophylli . 


. TTL IO = gtt. 20 


" Cinnamomi . 


til 10 = gtt. 20 


" Camphorae (Japonicum) 


. TTL IO = gtt. 20 


" Copaibae 


. til 10 = gtt. 20 


" Fceniculi 


. TTL IO = gtt. 20 


" Gaultheriae . 


. TTL IO = gtt. 20 


" Juniperi 


. TTL 10 - gtt. 20 


" Menthae Piperitse . 


. TTL IO = gtt. 20 


' ' Phosphoratum 


• TTL IO = gtt. 15 


" Tiglii . 


. TTL IO - gtt. 15 


Paraldehydum . 


. til 10 = gtt. 25 


Solutio Atropinae (not safe to 


trust to " drops") ttl 10 == gtt. 10 


" Cocainse I % " " " 


" " " ttl 10 = gtt. 10 


" Strychninae " " " 


" " til 10 = gtt. 10 


Spiritus ^Etheris Compositu 


s 


. til 10 = gtt. 25 



APPENDIX 


I 


Spiritus /Etheris Nitrosi TTj, 10 = gtt. 25 


" Ammonise Aromaticus 


. TTL IO = gtt. 25 


" " Chloroformi . 


. 171,10 = gtt. 25 


" " Glonoini 1 % 






. Tq, 10 = gtt. 25 


Tinctura Aconiti 






. TT[ IO = gtt. 25 


" " Fleming's 






. TU IO = gtt. 25 


' ' Belladonnoe 






. TT], 10 = gtt. 25 


" Digitalis 






. TTj, IO = gtt. 20 


" Ferri Chloridi 






. -rq, 10 = gtt. 25 


" Nucis Vomicae . 






, th, 10 = gtt. 25 


Opii . 






. TIj, IO = gtt. 20 


" Opii Camphor ata 






. TU, IO = gtt. 20 


" Opii Deodorata . 






, TTL IO = gtt. 20 


" Stramonii . . 






, TTj, 10 = gtt. 20 


" Veratri Viridis . 






. ttl to = gtt. 25 


Vinum Colchici Radicis . 






. TT[ 10 = gtt. 20 


" " Seminis . 






. TTJ, 10 = gtt. 20 


Opii . 






. TTL IO = gtt. 18 



97 



Note. — The ratio of drops to minims here given is only approxi- 
mate, and refers to drops as dropped from the edge of a bottle-neck 
of the style kept in the shops. It does not refer to drops such as are 
delivered from the fine point of an eye- or medicine-dropper. The 
sizes of the drops delivered by the latter are so varying that no 
reliable ratio to minims can be established. 

Charles Rice. 

New York, Feb. 14, 1890. 



INDEX. 







PAGE 




PACK 


Acetanilid . 


. 102 


Antimonium 


44 


Acetphenetidin . 


. 105 


Antipyrin . 


IOI 


Acidum Aceticum 


66 


Apomorphinse Hydrochloras 


; 123 




' Boricum 


• 65 


Argentum . 


22 




' Carbolicum . 


93 


Arnica . 


149 




' Citricum 


67 


Arsenicum . 


40 




' Hydrochloricum 


63 


Asafcetida . 


139 




' Hydrocyanicum 


69 


Atropina . 


161 




' Lacticum 


69 








' Nitricum 


62 


Balsamum Peruvianum 


134 




' Nitro-Hydrochlori- 




Tolutanum 


134 




cum . 


64 


Belladonna . . . . 


158 




' Oleicum 


106 


Benzoinated Lard 


190 




' Oxalicum 


72 


Benzoinum . 


151 




' Phosphoricum 


64 


Bichloride of Methylene 


85 




' Salicylicum . 


96 


Bismuthum 


46 




1 Sulphuricum . 


61 


Bitter Almond . 


136 




1 Sulphurosum . 


65 


Blaud's Pills 


33 


' ' Tartaricum 


68 


Brandy . . 


78 


Aconitine . 


in 


Bromine . 


51 


Aconitum . 


108 


Buchu . 


129 


Adeps Prseparatus 


190 


Burnett's Fluid . 


25 


Adonidine . 


113 






Adonis Vernalis . 


113 


Cacao Butter 


129 


Agaricus . ' . 


188 


Caffeine . 


147 


Alcohol 


73 


Calcium . 


15 


Aloe .... 


179 


Calomel . 


39 


Aluminium 


28 


Calumba . 


113 


Ammoniacum 


140 


Camellia Thea . 


147 


Ammonium 


12 


Camphora . 


170 


Amygdala Amara 


136 


Cantharis . 


191 


Amylene Hydrate 


90 


Carbon . 


60 


Amyl Nitras 


90 


Cascara Sagrada . 


132 


Ant 


ifebrin . 


102 


Cascarilla . 


172 



199 



200 


INDEX. 




PAGE 




Catechu 


. I46 


Glycerinum 


Cerium 


. 18 


Glycyrrhiza 


Cetaceum Spermaceti 


. I9O 


Gossypium . 


Chamomile . 


• 149 


Goulard's Extract 


Chinolin 


. IOO 


Guarana . 


Chloral 


• 85 


Gum Cotton 


Chloral Camphor 


. 88 




Chloral Hydras . 


• 85 


Hydrargyrum 


Chlorine 


• 50 


Hydro-Naphthol 


Chloroformum 


. 80 


Hydroquinone 


Cimicifuga . 


. 112 


Hyoscyamus 


Cinchona . 


. 141 


Hypnone . 


Coca . 


. 125 




Cocainre Hydrochlora& 


. 127 


Ichthyol . 


Codeina 


. 122 


Iodine . 


Coffea Arabica . 


. 146 


Iodoformum 


Colchicum . 


• 183 


Ipecacuanha 


Coll odium . 


. 129 




Colocynthis 


• 136 


Jaborandi . 


Conium 


• 138 


Kairin .... 


Convallaria 
Copper 


. 180 
. 26 


Kairolin . 


Coto . 


. 172 


Labarraque's Solution 


Cotton 


. 128 


Lanolin . . . 


Creasote 


. 96 


Lead ..... 


Creolin 


. IOO 


Lime . 


Croton Chloral . 


. 88 


Linseed . 


Croton Oil . 


. 172 


Lithium . 


Cuprum 


. 26 


Lobelia . 
Lunar Caustic 


Digitalis 


. 165 


Lupulus . 


Dobell's Solution 


. 96 


Lycopodium 


Duboisia 


. 164 


Magendie's Solution . 


Elaterinum 


• 137 


Magnesium 


Ergota 


. 186 


Manganesium 


Erythroxylon 


. 125 


Menthol . 


Ether 


• 83 


Mercury . 


Exalgine 


. 105 


Metachloral 
Monsel's Solution 


Fel Bovinum Purificati 


am . 189 


Morphina . 


Ferrum 


• 29 


Mustard .... 


Filix Mas . 


. 187 


Myrrha . 


Fleming's Tincture 


. in 




Fowler's Solution 


• 43 


Naphthalin 
Nicotine . 


Gelsemium . 


. 152 


Nitro-Glycerine . 


Glonoin 


• 92 


Nux Vomica 





INDEX. 


20I 




PAGE 




PAGE 


Oleum Gaultheri?e 


• 99 


Salicylate of Soda 


98 


" Juniperi . 


. 173 


Salol' .... 


. oS 


" Lavandulae 


. 168 


Saltpetre 


1 


" Mentha? Piperita 


169 


Sanitas 


177 


1 ' Morrhiue 


190 


Santonica . 


148 


Olivre 


152 


Scilla. 


178 


" Ricini 


173 


Scoparius . 


132 


" Rutoe 


130 


Seidlitz Powder . 


. II 


" Terebinthina; . 


176 


Senega 


124 


' ' Theobromre 


129 


Senna 


135 


'' Tiglii 


172 


Serpentaria 


171 


Opium 


114 


Silver 


22 






Sinapis 


123 


Pancreatin . 


189 


Sodium 


9 


Paraldehyde 


88 


Sparteine Sulphas 


133 


Pearson's Solution 


43 


Spigelia 


152 


Pepsin 


189 


Staphisagria 


in 


Peroxide of Hydrogen 


61 


Stramonium 


162 


Petrolatum . 


106 


Strophanthus 


157 


Phenacetine 


104 


Sulfonal 


89 


Phenoresorcin 


104 


Sulpho-Carbolate of Sodium 


96 


Phosphor . 


47 


Sulphur 


58 


Physostigma 


134 






Picrotoxin . 


114 


Tabacum . 


165 


Pilocarpus . 


130 


Taraxacum 


149 


Plumbum . 


18 


Tartar Emetic 


44 


Podophyllum 


in 


Thallin 


105 


Potassium . 


2 


Thiersch Powder 


99 


Pyridine 


105 


Thymol 


169 


Pyrocatechin 


105 


Tragacantha 


132 


Pyroxylinum 


128 








Urethan 


90 


Quassia 


131 


Valeriana . 


148 


Quinina 


142 


Vaseline 


106 






Veratrina . 


183 


Resorcin 


103 


Veratrum Viride 


181 


Rheum 


169 






Rochelle Salt 


8 


Warburg's Tincture . 


144 






Whiskey 


78 


Saccharin . 


106 


Wines 


79 


Saccharum Lactis 


188 






Salicin 


99 


Zincum 


24 


Salicinum . 


175 


Zingiber . 


178 









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